title: Public Reporting of Hospital-Specific Breastfeeding Measures.
abstract: BACKGROUND
  Establishing breastfeeding in the first days of an infant's life is important for longer term success in breastfeeding. In 2009, New York State (NYS) was the second state to require maternity care facilities to collect infant feeding information and to publicly disseminate hospital-specific infant feeding statistics. Public reporting of these statistics as performance measures is a strategy to prompt hospitals to improve breastfeeding support.
  
  
  OBJECTIVE
  This qualitative study sought to explore how maternity care administrators and clinical staff responded to the mandate for publicly reported performance measures and whether they used this information to improve maternity care practices.
  
  
  METHODS
  This study used a stratified random sample of NYS hospitals with maternity care units. Participants were recruited by email and telephone calls. A total of 25 hospitals participated in the study, and 37 hospital administrators and staff completed in-depth interviews by telephone. The interviews were analyzed using an explanatory framework in NVivo 8.
  
  
  RESULTS
  Publicly reported hospital-specific breastfeeding measures increased attention to breastfeeding performance. Hospital administrators and staff reported comparing their relative rankings to other hospitals in the state. Some hospitals used publicly reported breastfeeding measures to monitor performance, whereas others were prompted to generate additional measures for more frequent monitoring. Hospitals with relatively low breastfeeding statistics took certain actions to improve their maternity care practices to support breastfeeding. Limitations of the usefulness of publicly reported measures were reported by interview participants.
  
  
  CONCLUSIONS
  Publicly reported, hospital-specific breastfeeding measures may prompt hospitals to monitor and improve maternity care practices related to supporting breastfeeding.
authors: 1 Department of Health Policy, Management and Behavior, University at Albany School of Public Health, SUNY, Rensselaer, NY, USA.
authors: Janine M
authors: JM
authors: Jurkowski
authors: 2 Department of Social Work, Kutztown University of Pennsylvania, Kutztown, PA, USA.
authors: Juliana
authors: J
authors: Svistova
authors: 3 Office of Public Health Practice, New York State Department of Health, Albany, NY, USA.
authors: Trang
authors: T
authors: Nguyen
authors: 1 Department of Health Policy, Management and Behavior, University at Albany School of Public Health, SUNY, Rensselaer, NY, USA.|4 Policy and Research Translation, Division of Chronic Disease Prevention, New York State Department of Public Health, Albany, NY, USA.
authors: Barbara A
authors: BA
authors: Dennison
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000379:methods* / Q000706:statistics & numerical data; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D019221:Mandatory Reporting; D009518:New York; D016134:Organizational Policy; D011181:Postnatal Care / Q000379:methods / Q000706:statistics & numerical data; D036301:Qualitative Research
keywords: breastfeeding; breastfeeding rates; health policy; quality improvement; regulation