pqcnc ehm well ls3 what we have accomplished
TRANSCRIPT
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The EHM Well Odyssey
April 10, 2013
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EHM Well Baby
Goal:
Increase exclusive
breastfeeding rates by 50%
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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
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Close to Me
Partnership with March of Dimes Bilingual education for families & staff Educational materials Equipment
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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
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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
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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)
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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
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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
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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
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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
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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
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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
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Shifts With < 1 Hour of
Separation
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African American Mothers
Intention to Breastfeed
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Intention to Breastfeed All
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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
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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
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% 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
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Going Forward
This work must continue Data system will remain active Reports will be available QI Summer Patient and Family Engagement Next initiatives
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WhatismyUnitsCulture?
Thesetofsharedatudes,values,
goals,andpracFcesthatcharacterizesmyunitoraninsFtuFon,organizaFon
orgroup