title: Development of the breastfeeding quality improvement in hospitals learning collaborative in New York state.
abstract: Exclusive breastfeeding is a public health priority. A strong body of evidence links maternity care practices, based on the Ten Steps to Successful Breastfeeding, to increased breastfeeding initiation, duration and exclusivity. Despite having written breastfeeding policies, New York (NY) hospitals vary widely in reported maternity care practices and in prevalence rates of breastfeeding, especially exclusive breastfeeding, during the birth hospitalization. To improve hospital maternity care practices, breastfeeding support, and the percentage of infants exclusively breastfeeding, the NY State Department of Health developed the Breastfeeding Quality Improvement in Hospitals (BQIH) Learning Collaborative. The BQIH Learning Collaborative was the first to use the Institute for Health Care Improvement's Breakthrough Series methodology to specifically focus on increasing hospital breastfeeding support. The evidence-based maternity care practices from the Ten Steps to Successful Breastfeeding provided the basis for the Change Package and Data Measurement Plan. The present article describes the development of the BQIH Learning Collaborative. The engagement of breastfeeding experts, partners, and stakeholders in refining the Learning Collaborative design and content, in defining the strategies and interventions (Change Package) that drive hospital systems change, and in developing the Data Measurement Plan to assess progress in meeting the Learning Collaborative goals and hospital aims is illustrated. The BQIH Learning Collaborative is a model program that was implemented in a group of NY hospitals with plans to spread to additional hospitals in NY and across the country.
authors.affiliation: Bureau of Chronic Disease Prevention , New York State Department of Health, Albany, NY 12204, USA. emf06@health.state.ny.us
authors.forename: Eileen
authors.initials: E
authors.lastname: Fitzpatrick
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Dennison
authors.forename: Sara Bonam
authors.initials: SB
authors.lastname: Welge
authors.forename: Stephanie
authors.initials: S
authors.lastname: Hisgen
authors.forename: Patricia Simino
authors.initials: PS
authors.lastname: Boyce
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Waniewski
mesh_terms: D001942:Breast Feeding / Q000639:trends; D003299:Cooperative Behavior; D019317:Evidence-Based Medicine; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006292:Health Priorities / Q000639:trends; D006293:Health Promotion / Q000458:organization & administration*; D006771:Hospitals, Maternity / Q000458:organization & administration / Q000639:trends; D006801:Humans; D007231:Infant, Newborn; D009518:New York / Q000453:epidemiology; D016134:Organizational Policy; D011181:Postnatal Care / Q000458:organization & administration* / Q000639:trends; D011247:Pregnancy; D016730:Program Development; D058996:Quality Improvement / Q000458:organization & administration