PQCNC EHM Well LS3 What we have accomplished...

7/28/2019 PQCNC EHM Well LS3 What we have accomplished...

1/23

The EHM Well Odyssey

April 10, 2013


2/23

EHM Well Baby

Goal:

Increase exclusive

breastfeeding rates by 50%


3/23

Focus EHM Well

Skin to skin in DR The power of hand expression Skin to skin in postpartum Increasing Lactation Support

Staff educationLactation specialists

Removing formula Reducing separation of mom-baby Reducing pacifier use


4/23

Close to Me

Partnership with March of Dimes Bilingual education for families & staff Educational materials Equipment


5/23

EHM Well Enrollment

UCL

538.246

1625.538

CL

473.00

1509.000

LCL

407.754

1392.462

238.7

438.7

638.7

838.7

1038.7

1238.7

1438.7

1638.7

1838.7

2038.7

AggregateMonthlyDischarges

Oct'10-Mar'13

EHMWell:NewbornDsicharges


6/23

SPC Charts

Determining Significance1 point outside the upper or lower control

limits

2 of 3 successive points in the outer third ofthe control limit

8 successive points above or below the centerline

6 consecutive points increasing or decreasing

Benneyan JC, Lloyd RC, Plsek PE Statistical process control as a tool for researchand healthcare improvement. Qual Saf Health Care. 2003;12(6):458464


7/23

EHM Well: Breastfeeding Support

CL

0.484

0.6368

UCL

0.5525

0.6565

LCL

0.4146

0.6171

0%

10%

20%

30%

40%

50%

60%

70%

80%

%ReceivingBreasCeedingSupport

IniaveMonths

EHMWell:BreasCeedingSupport

78%IncreaseinBreas:eedingSupport

(Comfort,posiFon,latch,transfer)


8/23

EHM Well: Skin to Skin in L&D

CL

0.649

0.6784

UCL

0.71530.7202

LCL

0.5836

0.6366

0.000

0.100

0.200

0.300

0.400

0.500

0.600

0.700

0.800

%SkintoSkin

IniaveMonths

EHMWell:SkintoSkin

33%IncreaseinSkintoSkin


9/23

EHM Well: Pacifier Use

CL

0.1249

UCL

0.1385

LCL

0.1114

0.000

0.050

0.100

0.150

0.200

0.250

0.300

0.350

Mar-12 Apr-12 May-12 Jun-12 Jul-12 Aug-12 Sep-12 Oct-12 Nov-12 Dec-12 Jan-13 eb-13 Mar-13

ShiKsWithPacifierUse

Mar-12-Mar-13

PacifierUse

53%reducFonin acifieruse


10/23

EHM Well: Hand Expression

CL

0.442

0.3794

UCL

0.5104

0.4228

LCL

0.3734

0.3360

0.000

0.100

0.200

0.300

0.400

0.500

0.600

%MomsDemonstrangHandExp[ression

Oct'10-Mar'13

EHMWell:HandExpression

542%increaseinhandexpression


11/23

EHM Well:Breastfeeding

Support

CL

0.484

0.6368

UCL

0.5525

0.6565

LCL

0.4146

0.6171

0%

10%

20%

30%

40%

50%

60%

70%

80%

%ReceivingBreasCeedingSupport

IniaveMonths

EHMWell:BreasCeedingSupport

78%IncreaseinBreas:eedin Su ort


12/23

EHM Well: Postpartum Skin to

Skin

CL

0.444

0.4722

UCL

0.47710.4926

LCL

0.4116

0.4518

0.000

0.100

0.200

0.300

0.400

0.500

0.600

%ShiKsWithSkintoSk

in

Months

EHMWellPostpartumSkintoSkin

33%increaseinPost artumSTS


13/23

EHM Well: Shifts < 1 Hour of

Separation

CL0.416

0.6706

UCL 0.4840

0.6898

LCL

0.3480

0.6513

0%

10%

20%

30%

40%

50%

60%

70%

80%

Data1-

Data2

Oct'10-Mar'13

EHMWell:SeparaonofMomandBaby

53%IncreaseInRatesofShiZs

with


14/23

Shifts With < 1 Hour of

Separation


15/23

African American Mothers

Intention to Breastfeed


16/23

Intention to Breastfeed All


17/23

EHM Well: Mothers Intending to

Soleyl Breastfeed Succeed

CL0.7180UCL

0.7647

LCL

0.6714

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Mar-12 Apr-12 May-12 Jun-12 Jul-12 Aug-12 Sep-12 Oct-12 Nov-12 Dec-12 Jan-13 eb-13 Mar-13ExclusiveBreas

CeedinginMothersIntending

toBreasCeed

Mar-12-Mar-13

EHMWell:ExclusiveBreasCeedinginMothersIntendingto

BreasCeed

6%increaseinexclusivebreasfeedinginmother's

intendin tobreas:eed


18/23

EHM Well: Exclusive Maternal Milk

All

CL0.466

0.5208

UCL

0.5348

0.5655

LCL 0.3971

0.4761

0%

10%

20%

30%

40%

50%

60%

%SoleyMaternalMilk

IntervenonMonths

EHMWell:ExclusiveBreasCeeding


19/23

% Breastfed Infants Receiving

Formula Before 2 DOL

0

5

10

15

20

25

30

35

2009 2010 2011 2012

NC

US

Since 2010 38% reduction in formula for breastfed infants

http://www.cdc.gov/breastfeeding/data/reportcard.htm


20/23

Going Forward

This work must continue Data system will remain active Reports will be available QI Summer Patient and Family Engagement Next initiatives


21/23


22/23


23/23

WhatismyUnitsCulture?

Thesetofsharedatudes,values,

goals,andpracFcesthatcharacterizesmyunitoraninsFtuFon,organizaFon

orgroup

PQCNC EHM Well LS3 What we have accomplished...

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