title: Applying Collaborative Learning and Quality Improvement to Public Health: Lessons from the Collaborative Improvement and Innovation Network (CoIIN) to Reduce Infant Mortality.
abstract: Infant mortality remains a significant public health problem in the U.S. The Collaborative Improvement & Innovation Network (CoIIN) model is an innovative approach, using the science of quality improvement and collaborative learning, which was applied across 13 Southern states in Public Health Regions IV and VI to reduce infant mortality and improve birth outcomes. We provide an in-depth discussion of the history, development, implementation, and adaptation of the model based on the experience of the original CoIIN organizers and participants. In addition to the political genesis and functional components of the initiative, 8 key lessons related to staffing, planning, and implementing future CoIINs are described in detail.
  
  
  
  This paper reports the findings from a process evaluation of the model. Data on the states' progress toward reducing infant mortality and improving birth outcomes were collected through a survey in the final months of a 24-month implementation period, as well as through ongoing team communications.
  
  
  
  The peer-to-peer exchange and platform for collaborative learning, as well as the sharing of data across the states, were major strengths and form the foundation for future CoIIN efforts. A lasting legacy of the initiative is the unique application and sharing of provisional "real time" data to inform "real time" decision-making.
  
  
  
  The CoIIN model of collaborative learning, QI, and innovation offers a promising approach to strengthening partnerships within and across states, bolstering data systems to inform and track progress more rapidly, and ultimately accelerating improvement toward healthier communities, States, and the Nation as a whole.
authors.affiliation: U.S. Department of Health and Human Services, Maternal and Child Health Bureau, Health Resources and Services Administration, Rockville, MD, USA. rghandour@hrsa.gov.|Division of Epidemiology, Office of Epidemiology and Research, Maternal and Child Health Bureau, Health Resources and Services Administration, 5600 Fishers Lane, Room 18N122, Rockville, MD, 20857, USA. rghandour@hrsa.gov.
authors.forename: Reem M
authors.initials: RM
authors.lastname: Ghandour
authors.affiliation: Katherine Flaherty Consulting, Franklin, MA, USA.|Abt Associates, Cambridge, MA, USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Flaherty
authors.affiliation: U.S. Department of Health and Human Services, Maternal and Child Health Bureau, Health Resources and Services Administration, Rockville, MD, USA.
authors.forename: Ashley
authors.initials: A
authors.lastname: Hirai
authors.affiliation: U.S. Department of Health and Human Services, Maternal and Child Health Bureau, Health Resources and Services Administration, Rockville, MD, USA.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Lee
authors.affiliation: Abt Associates, Cambridge, MA, USA.
authors.forename: Deborah Klein
authors.initials: DK
authors.lastname: Walker
authors.affiliation: U.S. Department of Health and Human Services, Maternal and Child Health Bureau, Health Resources and Services Administration, Rockville, MD, USA.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Lu
mesh_terms: D006801:Humans; D007223:Infant; D007226:Infant Mortality; D000073919:Interdisciplinary Placement; D009936:Organizational Innovation; D015397:Program Evaluation; D011634:Public Health; D058996:Quality Improvement
keywords: Collaborative learning; Infant mortality; Quality improvement