N E W Y O R K C I T Y H O S P I T A L B R E A S T F E E D I N G C O L L A B O R A T I V E ( N Y C B H C )

COMMUNITY TRANSFORMATION GRANT

AGENDA

8:00 – 8:30am Registration

8:30 – 8:45am Welcome and Introductions

8:45 – 9:00amNYC Breastfeeding Hospital Collaborative: Project Goals & Overview

9:00 – 9:45amBaby Friendly USA: Lessons Learned to Successfully Progress on 4D Pathway

9:45 – 10:15am Project Approach & Prework Tasks

10:15 – 10:45am Baseline Data & Project Milestones (Extranet)

10:45 – 11:30am Introduction to NYC BHC Assessment Tool

11:30 – 11:45am Next Steps / Q&A

PROJECT GOALS

The goal of the New York City Breastfeeding Hospital Collaborative (NYC BHC) is to help support hospitals in their journey toward Baby-Friendly designation.

This includes tailoring the Learning Collaborative model to assist hospitals who are already on the 4-D pathway (Discovery, Development, Dissemination and Designation) in addition to supporting those hospitals which are just starting the journey

PROJECT OVERVIEW

Community Transformation Grant (CTG)

• Federal grant through the CDC

• Project Period: June 14, 2012 – September 30, 2016

• Each cohort will include:

• Three in-person Learning Sessions

• Bimonthly conference calls

• Customized coaching support

• Access to IHI Extranet for online resources and data reporting on core measures and key milestones

• Support for additional training (CLC , TTT and online tokens) and $ for Baby-Friendly pathway fees

ROLES AND RESPONSIBILITIES

Hospital Improvement teams will…

• Participate in the full Collaborative including all

learning sessions, conference calls and other NYC BHC

meetings and events

• Share challenges, success and best practices with

peer hospitals participating in collaborative

• Submit data monthly on key measures to the NYC BHC

extranet and track performance results and

implementation of key deliverables

ROLES AND RESPONSIBILITIES

Hospital Improvement teams will…

• Participate in NYC Breastfeeding Hospital

Collaborative Assessment Survey at the beginning and

end of the implementation periods to assess readiness

for 4D Designation

• Serve as faculty or provide peer mentorship to other

hospitals participating in the initiative to support the

collaborative learning process.

HOSPITAL IMPROVEMENT TEAMS

Cohort 1

1. Harlem Hospital Center

2. Lincoln Medical and Mental Health Center

3. Bellevue Hospital Center

4. Montefiore Medical Center

5. SUNY Downstate Medical Center

6. Jacobi Medical Center

7. Queens Hospital Center

8. Richmond University Medical Center

9. Metropolitan Hospital Center

10.Coney Island Hospital

PROJECT STAFF

DOHMH Staff:

• Dr. Lorraine Boyd

• Amber Ahmad

• Marta Kowalska

• Emily Magid

• Lusta Phanord

Joslyn Levy & Associates Staff:

• Joslyn Levy

• Patricia Simino Boyce

• Cari Reiner

Technical Experts:

• Trish MacEnroe, Baby Friendly USA

• Roger Edwards, Northeastern University

• Others

BABY FRIENDLY USA: LESSONS LEARNED TO SUCCESSFULLY

PROGRESS ON 4D PATHWAY

TRISH MACENROE

PROJECT APPROACH & PREWORK TASKS

PATRICIA SIMINO BOYCE, RN, PHD

APPROACH

• Three overlapping cohorts

• Integration of Learning & Implementation Models

• Milestones for Success (4D Pathway)

• Evidence-based Strategies(10 Steps)

• Measurement & Tracking

• BF Designation Readiness Survey

• Implementation Planning

• Leadership Engagement

• Technical Assistance

IHI BREAKTHROUGH SERIES(THE LEARNING MODEL)

Project Goals

NYC BHC

Project

Team

Curriculum

Design

NYC BHC Cohorts

Prework

LS 1BF

DesignationLS 3LS 2

Supports

Coaching Extranet

Training Measurement

NYC BHC Assessment Survey

LS = Learning Session

What are we trying toaccomplish?

How will we know that achange is an improvement?

What changes can we make thatwill result in improvement?

Act Plan

Study Do

THE MODEL FOR IMPROVEMENT

The Pathway to

Baby-Friendly® Designation

Hospital

Breastfeeding

Policy

Readiness

Interview

Implement

QI PlanCollect Data

Train Staff

Data

Collection

Plan

Prenatal/Postpartum

Teaching Plans

Staff Training

Curriculum

On-Site

Assessment

Start

Discovery

Development

Dissemination Designation

BF Committee

Or Task Force

BFHI

Work Plan

Register with

Baby-Friendly USAObtain CEO

Support LetterComplete Self

Appraisal Tool

Baby-Friendly

Designation

Bridge to

Development Phase-

Registry of Intent

Award

Bridge to

Designation Phase

Dissemination

Certificate of Completion

Bridge to

Dissemination

Phase-

Development-

Certificate of

Completion

Integrating the Learning Collaborative Model &

Pathway to Baby-Friendly® Designation

Hospital

Breastfeeding

Policy

Readiness

InterviewImplement

QI PlanCollect Data

Train Staff

Data

Collection

Plan

Prenatal/Postpartum

Teaching Plans

Staff Training

Curriculum

On-Site

Assessment

DiscoveryPrework

Development

LS1/AP1

Dissemination

LS2/AP2

Designation Planning

LS3/AP3

BF Committee

Or Task Force

BFHI

Work Plan

Register with

Baby-Friendly USAObtain CEO

Support LetterComplete Self

Appraisal Tool

Baby-Friendly

Designation

Bridge to

Development Phase-

Registry of Intent

Award

Bridge to

Designation Phase

Dissemination

Certificate of Completion

Bridge to

Dissemination

Phase-

Development-

Certificate of

Completion

Start

INTEGRATION OF MODELS

• Sequenced learning according to key deliverables for Baby Friendly Pathway• Collaborative Learning Model and to segment content on 10 Steps• Model for Improvement as method for testing changes in clinical practice, systems & culture • Individualized team coaching to implement milestones during Action Periods

NYC BHC TIMELINE

Activity Date

Learning Session 1 September 12 – 13, 2012

Action Period 1 September 2012 – January 2013

Learning Session 2 January 16 – 17, 2013

Action Period 2 January – June 2013

Learning Session 3 June 12 – 13, 2013

Action Period 3 July – September 2013

Launch Cohort 2 Late Summer/Early Fall 2013

PREWORK TASKS & MILESTONES

• Aim Statement Jun 29th

• Extranet Registration Jun 29th

• Baseline Data Jul 15th

• 4D Pathway Checklist Jul 15th

• Baseline Assessment Survey Jul 2012

• Target Goals Sep 7th

• 4D Deliverables Update Sep 7th

• LS1 Storyboard Sep 7th

• Register for LS1 Sep 7th

BASELINE DATA & PROJECT REPORTING

CARI REINER, MPA

MEASURES & REPORTING

• 11 Core Measures

• Monthly reporting

• All eligible births

• 4D Checklist

• Implementation Reporting

REPORTING REQUIREMENTS

Prework

(Jun 15 – Sep 11, 2012)

Action Periods

(Sep 14, 2012 – Jun 11, 2013

11 Measures Collect baseline data for each measure for one month (Jun 2012) and enter on extranet by July 15th

Report on data for each measure monthly (Sep 2012 through Jun 2013)

4D Deliverables Complete checklist andupload on extranet by July 15th

Provide update once per action period, prior to each LS

Project Reports None Provide monthly project reports (to be discussed at LS1)

EXTRANET REVIEW

• Team Resources

• Listserv

• Team Folders

• Reporting

• Uploads

• Project Reports

INTRODUCTION TO NYC BHC ASSESSMENT TOOL

ROGER A. EDWARDS, SCD

BACKGROUND

MA Department of Public Health is using CPPW $ to:

• Facilitate, encourage, and support Massachusetts Hospitals in the journey to Baby-Friendly through:

• 4 one-day trainings in May and June 2012

• one-hour follow-up webinars with each hospital individually

• one-hour webinar with a BFUSA representative

• Creation of a toolkit available on Mass.gov website*

• Track the effectiveness of the project with pre- and post-assessments

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*http://www.mass.gov/eohhs/provider/guidelines-resources/services-planning/family-health/perinatal-early-child-special-needs/child-care-health-and-safety/obesity-prevention/health-education-obesity/breastfeeding/becoming-baby-friendly-practical-solutions-toolkit.html

BACKGROUND:SYNERGIES

We are realizing synergies in MA with our focus on maternity care and breastfeeding from a PH perspective

Sustaining the momentum will enable us to continue to best leverage accomplishments so far

2009 - 20128% 47% participation inBaby Friendly Hospital Collaborative

2009 - 201280% 92% participation

201268% participation

201120102007, 2009, 2011

…and USBC Toolkits, Professional Society efforts, etc…

New

Standard

of Care

and

Healthier

Citizens

in the

21st

Century

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BACKGROUND: MA DPH PROJECT EFFECTIVENESS

• Phone –administered survey tool that covers all criteria required for Baby-Friendly certification

• Baseline assessments have been completed for approximately 2/3 of the 30 participating hospitals

• Post-training assessments will be completed 3 months after trainings

• Tracking of MA DPH toolkit website to identify number of visits and number of downloads of toolkit materials

• Surveys with specific feedback on each training from participants

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GOALS FOR NYC BHC TOOL

• Assess project effectiveness

• Project complete landscape of criteria required for certification

• Stimulate reflection about knowledge gaps

• Provide a mechanism for setting priorities and tracking progress

• Identify any uncertainties associated with specific criteria in an individual hospital context that can be directed to BFUSA

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OVERVIEW OF TOOL

• Tabs with each Step’s criteria

• Each criterion is rated as:0 = don't know1 = know we have nothing2 = partially3 = significantly4 = fully

• Some criteria will not apply to your hospital• With or without prenatal clinic or services• With or without special care unit

• Tabs with summary statistics that take applicable criteria into account

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OVERVIEW OF TOOL

29

OVERVIEW OF TOOL

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IMPLEMENTATION PLANNING

• Various options exist for utilizing the results of the tool for LS1 planning

• Selecting steps/criteria where solid progress has been made and completing remaining tasks to complete fulfillment of those requirements

• Select a step that is currently weak and target that domain

• Identify a common theme across steps, such as documentation and target that component

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PLANS FOR CONDUCTING BASELINE ASSESSMENTS

• You will be provided with the tool in advance

• You will go through the tool with a member of the NYC BHC team—it typically has taken ~1 hour

• ‘Don’t know what we have’ responses will trigger follow-up steps to help you prepare for LS1

• Hospital participation has varied

• One person representing the hospital

• 2-3 people present to discuss responses

• NYC BHC Project Team will work with teams to schedule a time slot in July 2012

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NEXT STEPS

• Register team members on Extranet

• Complete AIM statement

• Participate in Extranet Webex (July 10th at 11am)

• Submit baseline data

• Participate in Assessment Survey

• Prepare Storyboard for LS1

QUESTIONS & DISCUSSION

NYC BHC PROJECT TEAM