TODAY’S WEBINAR: Connecticut Breastfeeding Initiative (CBI) NEXT WEBINAR on June 25 th , 2013: Health Bucks (NYC farmers’ markets)
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TODAY’S WEBINAR: Connecticut Breastfeeding
Initiative (CBI)
NEXT WEBINAR on June 25th, 2013: Health Bucks
(NYC farmers’ markets)
Connecticut Breastfeeding Initiative (CBI)
Abby LoweCenter TRT, UNC ‐ Chapel Hill
and
Jennifer Matranga, BSN, RN, CCE, IBCLCConnecticut Breastfeeding Coalition (CBC) and
Consultant for the CBICaroline Smith Cooke, RD
Connecticut Department of Public Health
What We Will Cover ….
• Housekeeping• Overview of Center TRT• Overview of CBI• Public Health Impact of the
Connecticut Breastfeeding Initiative
• How the CBI works• Q and A
Housekeeping…
• If you are calling in on a phone line – turn your computer volume all the way down.
• Audio comes through more clearly through telephone line.
• Type questions into the chat window –we’ll respond during the Q & A portion
• All participant lines are muted• Technical difficulties – please use the chat
box
Center for Training and Research Translation
Center TRT – Web-Based Training
• Nutrition and Health Module – Nutrition 101– Policy and Environmental Supports for Healthy Eating
• Physical Activity and Health Module
• Intervention Specific Modules– Nutrition and Physical Activity Self Assessment in Child Care
(NAP SACC)– A New Leaf… Choices for Healthy Living
• RE-AIM (program planning and evaluation framework) – revised training coming late 2013
Center TRT – Intervention Translation
Connecticut Breastfeeding InitiativeAim of the CT Breastfeeding Initiative is to get multiple hospitals closer to designation via training, technical assistance and financial assistance.
• Training: In person training was offered (alternative options were also shared) to hospital maternity staff about the Baby Friendly principles
• Technical Assistance: Technical assistance hours with the consultant were allotted to each participating hospital.
• Financial Assistance: Each hospital received $4000 for designation costs and $750 for dissemination of educational materials to staff and patients/families
CBI Core Elements• Engage a Baby‐Friendly Hospitals expert.• Conduct info session to explain the initiative to hospitals.• Develop and implement a selection process to ensure that
enrolled facilities meet baseline criteria.• Provide the Baby‐Friendly USA Self‐Appraisal Tool to all
participating facilities for completion. • Deliver or support the delivery of the 15 lessons (Step 2). • Provide technical assistance, consulting time, and peer learning
opportunities to participating hospitals. • Provide financial assistance to participating hospitals. • Conduct a mock survey at the end of the TA/training period to
assess practice changes adopted and implemented and to inform the individual hospital of its readiness for review by Baby‐Friendly USA.
Potential for Public Health Impact• Reach –maternity staff & to babies/moms
• Effectiveness ‐moving hospitals towards
designation; changing maternity staff’s attitudes,
practices, and confidence
• Adoption of/participation in the program
• Implementation of the Ten Steps
• Maintenance of practices and Baby Friendly status
URL: http://www.centertrt.org/?p=intervention&id=1006
Connecticut Breastfeeding Initiative:From Start to Finish, Sustainability and Beyond!
A joint project of the Connecticut Department of Public Health (DPH) and the Connecticut Breastfeeding Coalition funded through American Recovery and Reinvestment Act (ARRA), Communities Putting Prevention to Work from
the Centers for Disease Control and Prevention (CDC).
Jennifer Matranga, BSN, RN, CCE, IBCLC, CBI ConsultantCaroline Smith Cooke, RD, CLC, CT DPH
Jennifer Matranga, BSN, RN, CCE, IBCLC
Connecticut Breastfeeding Initiative Consultant
CBC Board Member, former Chairperson
Be Ready! Project Background Program “written” prior to funding opportunity
Communities Putting Prevention to Work Funds $163,181 (ARRA funding)
Baby-Friendly Hospital Initiative United States: About 5% of births occur in maternity hospitals
designated Baby-Friendly At project’s start, Connecticut had 3 of 29 maternity hospitals
designated Baby-Friendly
National Baby-Friendly momentum
Leveraged existing partnerships
Connecticut Breastfeeding Coalition
Non-profit Organization
Incorporated in 2001
Convened by DPH
Mission: To improve Connecticut’s health by working collaboratively to promote, support and protect breastfeeding
Connecticut Breastfeeding CoalitionHighlights:
The Connecticut Breastfeeding Initiative
Connecticut’s 10 Step Collaborative
2012 PA 12-51 An Act Concerning Jury Duty for BF Mothers
The 2012 Hourly Employer Grant
Guide to CT’s Breastfeeding Non Discrimination and Workplace Accommodation Laws
Safe Sleep Committee
Statewide Conference Fall 2012
Connecticut Breastfeeding CoalitionProject Team
Michele Griswold, MPH, RN, IBCLC Chair CBC Co-director of CBI for CBC
Susan Jackman, MS, RD, CLC Board Member, former state breastfeeding coordinator Co-director of CBI for CBC
Jennifer Matranga, BSN, RN, CCE, IBCLC Board Member CBC Consultant to CBI hospitals
Chris Bracken, MSN, RN, IBCLC Board Member CBC Administrative Assistant for CBI
Be Collaborative
Create partnerships as a priority
Long-standing relationship with the Connecticut Department of Public Health
Long-standing relationships with “key” people in Connecticut’s maternity hospitals
Board of Directors with skills to oversee program
Project Activities Deliver 20-hours of training to maternity staff Achieves Baby-Friendly Step #2
Provide 40-hours of individualized maternity hospital consultation with Baby-Friendly expert
Foster collaboration and support between the ten maternity hospitals
Disseminate patient and staff education materials $750 per maternity hospital
Offer financial support for Baby-Friendly USA maternity hospital fees
Assist Hospitals towards Baby-Friendly Success
Tools, Policy → Tool kit
Training for Step 2
Showing the Ropes → Consultant
Committee and Hospital Buy-in
Be Resourceful:Don’t Reinvent the Wheel
Be Resourceful:Don’t Reinvent the Wheel
Help through the 4 D Pathway
Supplies
Venting of Challenges in Gatherings
Mock Survey
Sustainability possibilities for new collaborations?
March 2010 CBI Work Begins April 1, 2010 Transition to “4-D Pathway to Baby-Friendly
Designation”
With Great BFUSA Relationships We Were Ready to Help the Hospitals with the New “4-D Pathway”
Leading 10 Towards Designation
Be Realistic:Anticipate Challenges
Myths
Economic Barriers
System Change in Hospitals
Shifting Work
Power of Drug Companies
Time Management Critical Care Settings
Multidisciplinary Committee
Understanding WHO Code/Corporate Compliance
Evidence-Based Practice
Merging Hospitals
Be Well-Informed About Barriers: Both Real and Perceived
EducationSkin to Skin, Nurse First HourRoom-in → Feed Infant Frequently and
Exclusively by Infant Cue, Not the ClockEducate and Assist with Evidence-based Best
PracticeSupplement for Medical Indication OnlyCorporate CompliancePostpartum Resources
Baby-Friendly Elevator Speech
Why Is Baby Friendly So Hard?Our Maternal Child Healthcare People
Live in Our American Culture
Change is good you go first
Step 10 Foster Support Groups!!!
Steps Can Be Fun!
Data CollectionPower in NumbersmPincNational Immunization SurveyPatient Satisfaction SurveysChart AuditMock SurveyMom’s Survey: Every Step Counts
Be Data Driven:Use Data to Power Change
We’ll have no formula Truth: Follows corporate compliance and not take freebies from
pharmaceutical companies
All mothers must breastfeed Education is offered on benefits and it is encouraged but honors
mothers choice and offer safe formula prep education
It is too hard a goal to achieve By making a timeline to success it is a very achievable goal
No pacifiers allowed Education provided to avoid pacifiers until breastfeeding
established and pacifiers are utilized for painful procedures
Myths about Baby-Friendly
From This…
To This…
Ahhaa Moments!!!!!!!!!!
Over, Under or Around: Working Together Baby-Friendly is a Very
Achievable Goal!
DPH Project Team Division of Nutrition, Physical Activity and Obesity
• Stephanie Rendulic
The Special Supplemental Nutrition Program for Women, Infants and Children (WIC)• Marilyn Lonczak• Caroline Smith Cooke
Be Open to Opportunity
Be Invested- DPH’s role CT NPAO In-kind Project Management and Oversight Provided education materials ($750) per hospital Paid Baby-Friendly USA maternity hospital fees
State WIC Program In-kind Project Support
Local WIC Programs WIC staff participated in hospital lactation committees Peer counseling programs
Other Resources
Contracting organization project oversight (CBC)
Baby-Friendly expert consultant
Baby-Friendly trainer
Administrative Assistant
Training Curriculum
Training equipment and materials
Educational materials
Baby-Friendly USA Fees
1- Have a written breastfeeding policy that is routinely communicated to all health care staff.
2 - Train all health care staff in skills necessary to implement this policy.
4 - Help mothers initiate breastfeeding within one hour of birth.
7 - Practice “rooming in” –allow mothers and infants to remain together 24 hours a day.
10 - Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.
Goal: Assist ten Connecticut hospitals to achieve five Baby-Friendly steps
Be AnalyticalQuantitative
How many staff were trained?
Were any CBI hospitals designated?
Were the targeted Steps achieved?
Qualitative Phone interviews conducted
with the Breastfeeding Committee at each maternity hospital
Maternity staff on-line survey
Changes in Practice
Not addressed
Some Progress Made
Step achieved
Be Flexible
Moving in the Right Direction
Be Broad Thinking
Be Reflective to Move Forward
Lessons Learned Teleconference and Document
Sustainability Conference
Be Supportive
Ongoing Support isCritical toSustainability.
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