T EXAS DEPART MENT O F S TAT E HEALT H S ERVICES MULT I - PHASE APPROACH T O I MPROVE HOSPITAL MAT ERNIT Y PRACT I CES
T H E C U R R E N T S I T U AT I O N I N T E X A S 2
Texas WIC Infant Feeding Practices (2011 Texas WIC Infant Feeding Practices Survey, Texas Dept. of State Health Services) Ideal Response % of Mothers Reporting Baby placed skin-to-skin immediately after birth Yes 53.7% Able to hold baby for 30 minutes or longer in the first hour after birth Yes 60.0% Breastfed or attempted to breastfeed baby in first hour Yes 49.1% Received breastmilk at first feeding Yes 65.1% Exclusively breastfed during entire hospital stay Yes 30.0% Assisted with breastfeeding Yes 83.8% Roomed-in throughout hospital stay Yes 50.4% Baby spent one or more night out of room No 63.8% Told how to recognize when baby is hungry Yes 89.4% Told to breastfeed whenever the baby wanted Yes 74.3% Told to limit length of breastfeeding sessions No 32.3% Baby given pacifier while in hospital No 32.4% Mother given phone number for follow-up support Yes 69.1% Received formula marketing discharge bag No 22.0% Formula given to the mother or infant by staff without mother s request No 24.0% red indicates areas with most room for improvement 3
T E X A S A N Y A N D E X C L U S I V E I N - H O S P I TA L B R E A S T F E E D I N G : 2 0 0 5-2 0 0 9 The GAP is Growing Data Source: Linked Texas Vital Statistics, Live Births, 2005-2009. Newborn Screening Demographic Form feed field, 2005-2009. Prepared by: DSHS, OPDS, ELS, 10/05/2010 Note: Any breastfeeding includes infants whose demographic form was marked "Breastmilk only" or "Breastmilk & Formula".
M AT E R N A L S AT I S FA C T I O N The current situation leaves Texas women at a significant disadvantage for being able to meet their own infant-feeding goals. 75% Did you breastfeed as long as you wanted? Source: Centers for Disease Control and Prevention, 2007 Infant Feeding Practices Survey http://www.cdc.gov/ifps/results/ch3/table3-35.htm 5
m1 M O V I N G T O W A R D E X C E L L E N C E Continuum of DSHS support for quality improvement in maternity practices Right from the Start Trainings/ Resources Texas Ten Step Program Star Achiever Initiative Baby Friendly Hospitals
Slide 6 m1 Planned updates, to be made by SMAM: (1) restyle image with a taller background that is shaded the same brown as other TTS materials, (2) be sure that the star is floating centered vertically on the background. (It's current about to peek out of the bottom of the black background.) mindy, 1/17/2012
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T E X A S T E N S T E P P R O G R A M Requires breastfeeding policy that must address 85% of the Ten Steps Requires Texas Mother-Friendly Worksite designation Biennial re-designation TTS Program Coordinator 1 FTE (fully WIC-funded) Veronica.Hendrix@dshs.state.tx.us www.texastenstep.org 8
S TAT US O F T EXAS HOSPITALS 9
T HE DSHS PAT HWAY T O B ABY- FRIENDLY S T E P 1 : T E X A S T E N S T E P FA C I L I T Y Recognized by the State of Texas for support and promotion of breastfeeding through policy development, maternity care practices, and resources for breastfeeding mothers. S T E P 2 : S TA R A C H I E V E R I N I T I AT I V E Using a collaborative quality improvement model, the Initiative is designed to assist facilities as they work toward Baby-Friendly designation through Baby-Friendly USA. S T E P 3 : B A B Y F R I E N D LY The gold standard designation 10
S TA R A C H I E V E R I N I T I AT I V E 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: E-MAIL VISITS PHONE CONFERENCES MONTHLY TEAM REPORTS ASSESSMENTS LS: LEARNING SESSION AP: ACTION PLAN P-D-S-A: PLAN-DO-STUDY-ACT Model of Typical IHI Breakthrough Series learning collaborative 11
H O S P I TA L P O L I C I E S A F F E C T A L L E T H N I C I T I E S A N D I N C O M E L E V E L S Breastfeeding rates in U.S. Baby-Friendly hospitals exceed state and regional rates across all ethnicities and income levels. Breastfeeding rates are high in these hospitals, even among populations that do not traditionally breastfeed. Merewood, Pediatrics, 2005
T h e P o we r o f I n c r e m e n t a l C h a n g e Te x a s E x c l u s i v e B r e a s t f e e d i n g a t D a y 2 Non-TTS, Non-BFHI TTS, non-bfhi Texas BFHI Other 39.9 45.6 71.5 Hispanic 23.2 33.2 65.8 Black White 21.9 33.2 53.5 51.4 68.4 75.9 Texas exclusive breastfeeding prevalence, all facilities, all births: 41.6% 0 10 20 30 40 50 60 70 80 90 100 Data Source: Texas DSHS Office of Program Decision Support. Texas Vital Statistics, Provisional Live Births, 2009. Newborn Screening, 2009.
CONTACT S Tracy Erickson, BS, RD, IBCLC, RLC WIC Breastfeeding Coordinator Tracy.Erickson@dshs.state.tx.us Veronica Hendrix, LVN, IBCLC Texas Ten Step Coordinator Veronica.Hendrix@dshs.state.tx.us Julie Stagg, MSN, RN, IBCLC, RLC DSHS Breastfeeding Coordinator Julie.Stagg@dshs.state.tx.us www.texastenstep.org 14