Discuss the impact of improved maternity care practices Define the goal of the Texas Ten Step Star Achiever Breastfeeding Learning Collaborative

Transcription

1 TEXAS DEPARTMENT O F STATE HEALTH SERVICES 1

2 O BJECTIVES Discuss the impact of improved maternity care practices Define the goal of the Texas Ten Step Star Achiever Breastfeeding Learning Collaborative Describe the model of improvement used in the collaborative List two ways WIC local agency staff were utilized in the collaborative 2

3 Why Breastfeeding? IMPETUS FOR CHANGE 3

4 U N L E S S W E A R E M A K I N G P R O G R E S S I N O U R N U R S I N G E V E R Y Y E A R, E V E R Y M O N T H, E V E R Y W E E K, TA K E M Y W O R D F O R I T, W E A R E G O I N G B A C K. - F L O R E N C E N I G H T I N G A L E, Key Motivators: Improved health outcomes Mother s complaints Evidence- based training helps professionals Major health authority recommendations Federal government recommendations 4

5 % of mothers who breastfed < 6 weeks I N C R E A S E D N U M B E R O F BABY- F R I E N D LY H O S P I TA L P R A C T I C E S I N P L A C E D E C R E A S E S R I S K O F B R E A S T F E E D I N G C E S S AT I O N 30.0% 26.9% 21.5% Steps measured: Early breastfeeding initiation Exclusive breastfeeding Rooming-in On-demand feedings No pacifiers Breastfeeding information provided 15.5% 13.7% DiGirolamo, Pediatrics, % 3.2% Number of Baby-Friendly steps mothers reported experiencing 5

6 B R E A S T F E E D I N G Q U A L I T Y I M P R O V E M E N T: FA C I L I T Y B E N E F I T S Evidence-based practices are standard Increased facility space Increased patient satisfaction and safety Elevation of staff morale and teamwork Enhanced facility reputation Less staff absenteeism 6

7 Moving Hospitals toward Excellence in Infant Nutrition and Care STAR ACHIEVER LEARNING COLLABORATIVE 7

8 D S H S S U P P O RT C O N T I N U U M AWARENESS ACTION ACHIEVEMENT Right from the Start Campaign Trainings/ Resources Texas Ten Step Program TTS Star Achiever Baby Friendly Hospitals Continuum of DSHS support for quality improvement in maternity practices 8

9 STAR ACHIEVER- OVERVIEW Collaboration between: Texas Department of State Health Services (DSHS) The National Initiative for Children s Healthcare Quality (NICHQ) Funded by WIC 9

10 STAR ACHIEVER - I M PLEMENTATION Program launch date December 2012 Texas divided into three cohorts based on public health region Goal of 27 facilities from each cohort for a total of 81 hospitals Selected based on application, data collection by facility Completion of all cohorts 2016 Final review- January through June of

11 STAR ACHIEVER - G O AL Increase exclusive breastfeeding throughout Texas in the immediate postpartum period (in-hospital) Connect mothers with postpartum discharge support services 11

12 EVERYONE TEACHES, EVERYONE LEARNS Texas Ten Step Star Achievers Texas Ten Step Stars Enter Collaborative as TTS designated facilities Follow basic application guidelines Strongly encouraged to enter Baby-Friendly pathway during cohort period Enter collaborative as TTS/BFHI designated facilities Follow basic application guidelines TTS facilities that achieve BFHI designation during or after cohort period will be recognized as TTS Star Achievers

13 Develop and Implementing Change MODEL FOR IMPROVEMENT 13

14 T H E P D S A C Y C L E Four key elements of successful process improvement: What are we trying to accomplish? 1. Specific and measurable aims 2. Measures of improvement that are tracked over time 3. Key changes that will result in the desired improvement 4. A series of testing cycles How will we know that a change is improvement? What changes can we make that will result in improvement? ACT PLAN STUDY DO Source: Associates in Process Improvement 14

15 M O D E L O F T Y P I C A L I H I B R E A K T H R O U G H S E R I E S L E A R N I N G C O L L A B O R AT I V E RECRUIT, ENROLL, AND ENGAGE PARTICIPANTS REFINE FRAMEWORK, CHANGES, MEASURES LS1 LS2 LS3 AP1 AP2 AP3 SUMMATIVE CONGRESSES AND PUBLICATIONS SUPPORTS: VISITS PHONE CONFERENCES MONTHLY TEAM REPORTS ASSESSMENTS LS: LEARNING SESSION AP: ACTION PLAN P-D-S-A: PLAN-DO-STUDY-ACT Source: Institute for Healthcare Improvement, 2003: The Breakthrough Series: IHI s Collaborative Model for Achieving Breakthrough Improvement 15

16 PROJECT TIMELINE Cohort A: October 2012-January 2014 Cohort B: January 2014-May 2015 Cohort C: June December 2016 Learn, Sustain and Spread: January-June

17 North Texas COHORT A

18 T E X A S H E A LT H S E R V I C E R E G I O N S ( H S R S ) Cohort A: HSR 1-3 Cohort B: HSR 4-7 Cohort C: HSR

19 COHORT A PARTICIPANTS 20 hospitals accepted 18 Texas Ten Step designated 2 non-tts 4 Baby Friendly 19

20 COHORT A - LESSONS LEARNED Application challenges: Schedule conflicts Short application deadline Low breastfeeding interest as initiative Recruitment challenges: Dissemination of information Coordination of efforts

21 Bridging the Gap WIC INVOLVEMENT 21

22 ASSEMBLE AN EFFECTIVE TEAM Administrative leader Physician leader from obstetrics/pediatrics/ family medicine Nurse manager and staff nurse - Labor/delivery/postpartum/nursery care Senior lactation patient care staff member WIC/public health representative - WIC Director, BF Coordinator, Peer Counselor Mother whose baby was born at the hospital within the past three years

23 WIC STAFF ROLES AND RESPONSIBILITIES Recruitment Contact local hospital with application information Obtain key facility contact information Find parent representation Serve on facility planning team Maintain Spread Encourage use of social media to provide information updates Educate community about collaborative Engage Community Stakeholders Provide continued breastfeeding education and WIC program information

24 DSHS I NFO GRAPHIC

25 WHERE ARE WE NOW? Second learning session scheduled for June Scheduled Star Achiever discussions in other regions of Texas in conjunction with WIC Providing soft touch calls to Team Leaders Increased resources available -TexasTenStep.org 25

26 KEY RESOURCE LINKS sources-and-tools/ (Star Achiever hospital toolkit) (NICHQ -Star Achiever information) pdf (DSHS Initiatives Continuum Info-Graphic)

27 F O R M O R E I N F O R M AT I O N O R Q U E S T I O N S, P L E A S E C O N TA C T: Veronica Hendrix, LVN, IBCLC, RLC Texas Ten Step Program Coordinator Nutrition Education Services Branch Special Supplemental Nutrition Program for Women, Infants and Children (WIC) Texas Department of State Health Services (512) Follow Star Achiever on Twitter! 27