Texas breastfeeding learning collaborative: Using quality improvement to promote breastfeeding statewide

One of the most highly effective preventative measures a mother can take to protect the health of her infant and herself is to breastfeed, however, only 16 percent of U.S. mothers, and 13.7 percent of Texas mothers, breastfeed exclusively for six months. NICHQ (the National Initiative for Children's Healthcare Quality) is working with the Texas Women, Infants and Children (WIC) program and the Texas Department of State Health Services (DSHS) to run a team-focused quality improvement project centered on learning, sustainable change and innovations. This learning collaborative will help Texas hospitals improve exclusive breastfeeding rates inside and outside the clinic through the Texas Ten Step Star Achiever Program. The Texas Ten Step program is part of a larger state effort to help hospitals move toward “Baby Friendly” status, a designation given to hospitals that adhere to ten steps of promoting breastfeeding. These steps, as outlined by the World Health Organization WHO/UNICEF Baby-Friendly Hospital Initiative, include training staff on how to promote and support breastfeeding and eliminate the use of formula unless medically indicated. Learning how to apply evidence-based recommendations into actual practice has vast public health significance. It empowers providers with the knowledge and skills to develop and test rapid cycles of change, understand run charts, and make improvements, which in turn builds support commitment and sustainability of change. In this session, we will overview the project background and design as an example of a promising model for implementing QI in public health systems as well as share results to-date from the first of three cohorts of participating hospitals. This is session 2 of 4 in a panel titled, “Applying quality improvement in public health systems for maternal and child health.”