355 - A Healthcare System Collaborative Approach to Lactation Quality Improvement

Publication Number: 3342.355

Shelly s. Shallat, OSF Healthcare Children's Hospital of Illinois, Peoria, IL, United States; Jordan Barone, University of Illinois College of Medicine, Peoria, IL, United States; Ginger Barton Quick, OSF Healthcare Children's Hospital of Illinois, Mapleton, IL, United States

Background: Breastmilk is the optimal source of nutrition for infants. Within OSF Healthcare (a system serving diverse populations across Illinois and Michigan), only 51% of infants were exclusively breastfed at discharge prior to January 2022. Due to complex factors, breastfeeding initiation rates are lower in black birthing parents, and patients with Medicaid. Insufficient training of healthcare providers contributes to suboptimal breastfeeding rates. Large healthcare systems provide unique opportunities to share data, training materials, and project management to improve breastfeeding exclusivity rates.

Objective: Seven OSF Healthcare birthing hospitals aimed to increase aggregate breastfeeding exclusivity rates during the birth hospitalization for term level one newborns by 10% of baseline by June 2024. A secondary aim was to decrease racial and socioeconomic disparities in breastfeeding rates by increasing the rate by 20% of baseline for Black patients and Medicaid patients.

Design/Methods: A multidisciplinary quality improvement (QI) initiative included multiple Plan-Do-Study-Act (PDSA) cycles. A collaborative work group from all birthing facilities met monthly. All facilities completed the EMPower Best Practices (2021) optimal infant nutrition and equity QI initiative. American Board of Pediatrics Maintenance of Certification (MOC) part 4 credit for physician participation was obtained. Donor breast milk was initiated in all nurseries. A supplementation algorithm with education was created and disseminated.

Results: Over 80% of nursing staff in the level 1 newborn nurseries completed EMPower training. Ten physicians obtained MOC part 4 credit. Participating institutions saw an increase in exclusivity rates. The aggregate rate across all seven hospitals enrolled in this QI initiative increased from a baseline of 51% to 59%, representing an increase of 16% of baseline. Exclusive breastfeeding rates in Black and Medicaid patients increased from 23% to 33% (Black) and 34% to 41% (Medicaid), representing 43% and 20% increases from baseline, respectively.

Conclusion(s): A collaborative, system wide approach to lactation utilizing shared data and project management can decrease redundancy, gather voice, and facilitate support from leaders. EMPower Best Practices provided tools, structure, and accountability. Multidisciplinary training and system wide partnership can successfully improve breastfeeding rates and decrease disparity across healthcare systems.

All Birth Hospitals Newborn Stay Exclusivity Breastfeeding Rates
PAS abstract images.pdfAll Birth Hospitals Exclusivity Breastfeeding Rates

All Birth Hospitals Newborn Stay Exclusivity Breastfeeding Rates - Medicaid
PAS Medicaid.pdfAll Birth Hospitals Newborn Stay Exclusivity Breastfeeding Rates - Medicaid

All Birth Hospitals Newborn Stay Exclusivity Breastfeeding Rates - Self identified Black Race
PAS Black.pdfAll Birth Hospitals Newborn Stay Exclusivity Breastfeeding Rates - Self identified Black Race