Virginia Aims for a Zero

Sending a Loud and Clear Message on Safe Sleep to Communities

When a 2014 report showed one child almost every three days in Virginia died related to a preventable unsafe sleep environment, leaders at the Virginia Department of Health knew it was time to take action.

“Everyone wants their baby to thrive, but too many people don’t know the risk factors and protective measures for safe sleep environments,” says Shannon Pursell, MPH, Maternal and Infant Health coordinator at the Virginia Department of Health (VDH). “We want to change that.”

The VDH became a part of the NICHQ-led Infant Mortality Collaborative Improvement and Innovation Network to Reduce Infant Mortality (Infant Mortality CoIIN) in 2014, with an initial focus on identifying and promoting safe sleep practices through hospitals. The plan was to drive safe sleep education and policy at the hospital level for both the healthcare providers and the patients in neonatal intensive care units and maternity wards. 

Before the Infant Mortality CoIIN, organizations across the country acted independently with efforts to reduce infant mortality and didn’t necessarily know how to make an impact on such a multifaceted problem nor know what has already been tried and if it worked or not. NICHQ’s collaboration and data tracking platform, the Collaboratory, allows state improvement teams in the Infant Mortality CoIIN to connect with each other and ideas.

“We bring together organizations that are all trying to make improvements in the same target areas,” says NICHQ’s Executive Project Director Pat Heinrich, RN, MSN. “Without silos of information, more groups can make a bigger impact in less time.” 

Pursell agrees, “NICHQ’s Collaboratory has been instrumental to our team. It’s fantastic to see what other states are doing, what’s worked, what hasn't. We are able to take another’s work and ask how we can improve on their successes or change it without having to reinvent the wheel.” 

For example, Pursell took a website idea from Kentucky and purchased a domain name for VDH found NICHQ’s quality improvement tools to be an exceptional resource as well. 

“We followed NICHQ’s core change package, which gives you evidence-based solutions, to a ‘T.’ We decided what end results we wanted and then got started. NICHQ provided the legwork; we just had to fill in the blanks. It was a tremendous time saver,” says Pursell. 

One of the first action items was to do an extensive environmental scan to gather information on current safe sleep programs throughout the state. From hospitals to health departments, OB offices and community coalitions, the VDH found many groups making independent efforts on education about safe sleep, but without a consistent message. 

After connecting with the 35 district health departments in the state, Pursell created a “one stop workplace” for the 17 sites working on safe sleep education in Virginia. She conducts an in-depth 2-hour virtual training to educate the staff on safe sleep—what it is, what it looks like, where they can make an impact, and how to reach out into their local community. 

VDH also connects with home visiting services, available to at-risk families in different parts of the state. The Infant Mortality CoIIN team continues to work with these home health organizations to educate providers on:

  • correct methods for safe sleep
  • how to communicate a consistent message
  • training on motivational counseling
  • how to have difficult conversations about making changes for the safety of the infant while maintaining a positive rapport. 

“Soon our safe sleep website will be live. We are hopeful this will be the one place the entire state can use for consistent information and messaging,” says Pursell. 

Pursell knows change happens after repetitive exposure to new information, and wants the website and the promotion of safe sleep to saturate the community. The state established partnerships with existing online platforms, such as text4baby, where it can customize messages to the recipients and direct them to state-specific resources. It is also sending out the message of safe sleep to hospitals, community organizations, pediatricians and obstetricians so it is heard loud and clear by the community. 

“We will know our efforts were successful when our infant death rate due to an unsafe sleep environment is zero,” says Pursell.