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Review of EHM Mother BabyOctober 2010-October 2011

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EHM Well

• Expert Team Met June-September 2010• Identified patient population and scope of

project (Shift reporting on sample of allinfants based on JC methodology)

• Claimed our Aim – A 50% increase in the use of Exclusive Human

Milk in Mother-Baby Units

• Developed Action Plan – Keep mom and baby together – Support breastfeeding and milk expression – Limit formula availability

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EHM Well

• Action Plan

 – Skin to Skin (L&D and M-B Unit)

 – Couplet care

 – Breastfeeding support

 – Hand Expression

 – Restricting formula access

 – Exclusive human milk use

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EHM Well

• 1st Learning Session (Jan 2011) – Breastfeeding Support – Skin to Skin – State Efforts – Patient/family presentations

 – Action plan overview – Team building

• 2nd Learning Session (May 2011) – Eliminating supplementation – Family perspective

 – Team discussions• Weekly email newsletters• Monthly webinar meetings

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EHM NICU Discharges

0200

400

600

800

1000

1200

1400

     O    c     t

     N    o    v

     D    e    c

     J    a    n

     F    e     b

     M    a    r

     A    p    r

     M    a    y

     J    u    n    e

     J    u     l    y

     A    u    g

     S    e    p     t

     O    c     t

Discharges

Discharges

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Skin to Skin in L&D

Caucasian

All

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Skin to Skin L&D Reasons

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No Skin to Skin ReceivingEncouragement

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Breastfeeding Support EveryShift

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Moms Demonstrated Hand Expression

Hispanic

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Moms Demonstrated Hand Expression“Unknown” 

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Number of Times Skin to Skinfor One Hour

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Babies Separated < 1 Hour Any Shift

Caucasian

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Babies Separated < 1 Hour Any Shift“Unknown” 

Caucasian

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Indications for Supplement

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Exclusive Milk FeedingAll African American

Caucasian

Hispanic

TEAMWORK

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TEAMWORK

Alone we can do

so little, together wecan do so much.

Helen Keller

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Think Big

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Think Big

• The work you have done

• The work you will do

• What other people think about your work – AHA

 – DMA

 – DPH

 – State Legislature

 – BCBSNC and Office for Rural Health andCommunity Care

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Phase 2 EHM Mother BabyEHM Well

• Based on evidence

• Based on experience

• Combine with ongoing initiatives

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Phase 2 EHM WellEHM Mother Baby

• Focused Action Plan

 – What is our area of operations?

 – What is our mission?

 – What are 1…or…2…or 3 key elements 

• Support in house decision regarding breastfeeding

• Keep moms and babies together

 – Skin to Skin – Couplet care

• Reduce formula exposure

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Getting There

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Phase 2 EHM Mother BabyEHM Well

• Our compass on this mission

 – Data collection

• Minimalist

 – Guides the work, is not the work

 – Sampling vs all babies

• If it creates new work is seen by leaders assomething we need to improve

 – Identify those key metrics worthy of your timeto measure

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Clinical Decision Support

Data

Interface Engine

Knowledge

Relay

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Think Big