IMPROVING BREAST-FEEDING SUPPORT - A COMMUNITY-HEALTH IMPROVEMENT PROJECT

Background: Because of the brevity of the post-partum hospital stay, m others and their newborns are discharged home before breastfeeding is well established. In 1992, feedback from patients who had given birth at Fletcher Allen Health Care (Burlington, VT) suggested a need for mo re consistent, expert, and timely assistance with breastfeeding in the hospital and better continuity of care during the first few weeks at home. Quality improvement team: In 1993 a team developed objectives, a nalyzed the problem and possible solutions, and made eight recommendat ions on how the hospital could do more to promote breastfeeding. Imple mentation by team members and hospital staff included policy developme nt, staff education, acquisition of funding, a visiting professorship, development of a lactation consultant coordinator and team, and patie nt surveys to evaluate the program. A late 1994 survey of 63 postpartu m patients on their day of discharge indicated a high level of satisfa ction with breastfeeding support in the hospital. Current status: Acti vities are being undertaken for lactation consultation coverage, furth er policy development,implementation of nurse competency validation, i mproved patient and family education materials, and continued evaluati on of the breastfeeding support program through patient surveys. Concl usion: In the face of barriers such as the project's large scope, a pa ucity of internal team members, and a large number and variety of reco mmendations, some of the recommendations and follow-up plans have yet to be implemented. Yet the project has yielded improvements in care an d provides a model of how hospitals can expand their traditional bound aries of care and quality improvement into community health issues.