Updates

August 30, 2012

 

As a result of extensive discussions during our last learning session and to better track some of the work we are doing on key interventions we've added a new question to our data collection tool - time to first pumping.  Bringing down this time is one of the keys to long term success...

We were also reminded this month that we are not alone in the work we are doing - all across the country teams are focusing on similar initiatives.  As a result, Breastfeeding rates continue to rise, with increases of about 2 percentage points in breastfeeding initiation, and breastfeeding at 6 and 12 months. Breastfeeding initiation increased from 74.6% in 2008 to 76.9% in 2009 births. This improvement in initiation represents the largest annual increase over the previous decade. Breastfeeding at 6 months increased from 44.3% to 47.2%; breastfeeding at 12 months increased from 23.8% to 25.5%.

More here

August 21, 2012

Where:  Carolina Club / George Watts Hill Alumni Center, 150 Stadium Drive, Chapel Hill, NC

When: Thursday, October 4, 2011 9:30 - 3:30

What:  Up to three team members - all three primary team members (physician champion, nurse champion, senior hospital administrator) are encouraged to attend.  Lunch and materials will be provided at no cost. 

Directions

How: Register here



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July 30, 2012

 

In addition to continuing the day to day work of collecting and analyzing data and planning and executing PDSAs teams took a moment to check up, check in, and review looking at a variety of areas including - 

1) Who is on your team - who are the folks engaged and contributing to the work of the team?  Do you have a physician leader? A nursing leader? An executive leader? A family leader?  Who looks at the data as it's collected and are they part of the team effecting change?

2) Celebrate success - an area of the action plan that you've focused on, addressed, and what success looks like.

3) Refocus on one lingering challenge - an area of the action plan that you've focused on, but on which you just can't seem to get traction.

4) Stop five random folks in your unit - are they aware that your unit is participating in the initiative? Do they understand the goals of the initiative? 

June 30, 2012

Some highlights from last months learning session are available online including a presentation on the business case for lactation services. More here

May 30, 2012

In the NCCC LS 8 of our 13 teams focused on developing action plans that either shorten time to first pumping for mothers or assure mom is being discharged with at least a just in time pump, secured at discharge or on the way home after being discharged.  Centers described a number of approaches to these critical action plan considerations. Included were an order in OB order sets that requires mom be instructed in and offered the opportunity to pump after delivery, use of "pump" magnets or labels to alert maternal staff to need to attend to support a mom's pumping, needs, discussing the need for pumping at the same time consent for transfusion is obtained from parents, formalizing communication bewteen maternal and NICU nursing staff, and physicians/NNPs incorporating discussions of mom's pumping status as part of admission and rounds procedure in the NICU. Once center discussed their targeted efforts on increasing pump availability to mom's at discharge via communication with the WIC office pre-discharge of the mother.
 
All agreed that communication and education of the importance of maternal milk is a critical foundation for all these efforts. These efforts need to target not only mothers but staff. Several centers commented on the persistent willingness of some staff to refuse to accept the clearly demonstrated benefits of maternal breast milk on nutrition for the premature infant. All teams were necouraged to continue efforts to recruit medical provider support in these efforts. Several attendees discussed the need to more effectively communicate the work of the PQCNC EHM team to all staff members.
 
Pumping logs were discussed, specifically the development of a pumping log that best supports our work and is engaging for families. Forsyth, Gaston and UNC agreed to consider this and prepare a concept log for possible reproduction via PQCNC.
 
Family presentations reported two decidedly different hospital expereinces related to pumping and caring for a hospitalized extremely preterm infant. These conversations made it clear that when we seek patient and family input, we are exposed to views related to our care we might never appreciate. All were encouraged to seek family members to become part of their EHM team.
 
Keep up the great work everyone. The efforts to improve practice and deal with key drivers outline din the action plans is clearly occuring. Critical also is that we develop methods at our hsoptials to enter the data that supports the great work being done!

May 7, 2012

Currently 11 hospitals are collaborating to increase the exclusive use of human milk for ELBW babies. This month these teams have been collecting baseline data in order to understand the current practices and rates of exclusivity in preparation for the upcoming Learning Session in May.

May 7, 2012

The expert team for the Human Milk Initiative - NCCC Track has been working by conference call and email to determine measures, develop a data collection instrument and to create an action plan for this project.

May 7, 2012

The Human Milk Initiative Phase II - NCCC Track is designed to increase the availability and use of mother’s milk for ELBW babies in the Newborn Critical Care Centers (NCCC). Currently we have the following hospitals registered for this Human Milk Initiative:

Forsyth Medical Center
The Women's Hospital of Greensboro
Gaston
Presbyterian
University of North Carolina Hospitals
Duke University Hospital
WakeMed
Cape Fear Valley Medical Center
FirstHealth of the Carolinas Moore Regional Hospital
New Hanover Regional Medical Center
Carteret General

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