Systems Design

  • States Put the Squash on Smoking During Pregnancy

    Posted July 24, 2015 by NICHQ

    One of the core strategies for lowering the U.S. infant mortality rate is to reduce smoking before, during and after pregnancy. Smoking during pregnancy is associated with multiple fetal health risks, including sudden unexpected infant death. Currently, 21 of 53 states and territories that are part of the Collaborative Improvement and Innovation Network to Reduce Infant Mortality (IM CoIIN) are testing different smoking cessation methods in their communities.

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  • Alaska Shows Perinatal Regionalization Works to Reduce Infant Deaths

    Posted July 13, 2015 by Kristie Velarde

    When Stephanie Birch, RNC, MPH, MS, was a new nurse in 1982, Alaska’s infant mortality rate was the highest in the nation. More than 30 years later, Alaska sits at the opposite end of the spectrum, with the lowest rate of infant deaths. While it wasn’t a quick fix, Birch says Alaska shows significant improvement is possible. "You have to be willing to be open to the possibilities for improvement,” she says. “And, don’t give up.”

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  • Retraining Staff to Prioritize Breastfeeding

    Posted July 09, 2015 by Rachel Kremen

    About 80 percent of the women giving birth at CHRISTUS Hospital - St. Elizabeth in Beaumont, TX breastfeed with 50 percent exclusively breastfeeding during their stay. The exclusive rate is up 13 percent from just two years ago. The increase is a result of considerable efforts to retrain staff, eliminate formula giveaways, prioritize skin-to-skin bonding between mother and baby, and educate pregnant women about the benefits of breastfeeding.

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  • 5 Key Elements of High-Performing Pediatric Care Coordination

    Posted July 07, 2015 by NICHQ

    A new paper from NICHQ presents a framework from improving care coordination services in pediatric primary care. Derived from lessons learned from the Massachusetts CHIPRA Medical Home Learning Collaborative, the paper address five key elements of high-performing pediatric care coordination.

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  • LARC Accessibility, Knowledge Key for Better Interconception Care

    Posted April 15, 2015 by Rachel Kremen

    Contraception is often the last thing on a woman’s mind right after her baby is born. But increasing maternal access to long-acting reversible contraception (LARC) immediately after delivery could have a positive impact on the health of the newborn and future siblings.

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  • The Secret to Increasing Hospital Breastfeeding Rates

    Posted April 09, 2015 by Emily Trask

    As hospitals work to increase exclusive breastfeeding rates, they are often challenged by staff members who are resistant to new processes and workflows. Several hospitals are successfully overcoming this obstacle by fostering staff change agents who are involved in the decisions on changes to existing workflows.

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  • What’s Behind NYC's Drastic Decrease in Infant Mortality Rates?

    Posted April 07, 2015 by Cindy Hutter

    The saying, "if you can make it here you can make it anywhere," of New York City, holds true for even its youngest members. New York City’s infant mortality rate - 4.6 deaths per 1,000 live births in the first year of life - is nearly 30 percent lower than the US rate. What’s the city’s secret?

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  • Making the Case for Using an Internal PTF for Medical Homes

    Posted April 03, 2015 by Cindy Hutter

    In our new white paper, Cultivating Internal Change Agents for Medical Home Transformation, learn about an innovative approach to training internal practice transformation facilitators (PTFs) for medical home implementation efforts.

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  • Patient Passports Bring Us One Step Closer to a Patient-Centered Healthcare System

    Posted March 19, 2015 by Cindy Hutter

    NICHQ’s Chief Financial Officer and ardent patient engagement advocate, Tom Dahlborg, MSM, has written extensively about the need for patient-centered care. Dahlborg represents NICHQ on the National Quality Forum’s patient and family engagement action team. The team recently released a Patient Passport tool that encourages better patient engagement with providers.

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  • Viewing Health as a System

    Posted March 07, 2014 by Charlie Homer, MD, MPH

    Improvement science teaches us to view outcomes—such as health—as the inevitable product of a system, with the implication that achieving improved outcomes requires changing the system itself. A deep understanding of the system and how it functions can enable smarter decisions about selecting high leverage changes in order to improve system performance.

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  • Far From a Gold Medal Performance

    Posted February 28, 2014 by Jonathan Small, MBA

    We have a long way to go before we get a gold medal in child health outcomes. I suggest we begin in a humble place – with the recognition that, while we may have much to teach other countries, we also have a lot to learn.

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  • The Secret Ingredient to Fixing Systems Problems

    Posted February 12, 2014 by Cindy Hutter, MBA

    The mantra in quality improvement is “every system is perfectly designed to get the results it gets.” Regardless of your system of choice—your workplace, your home, your community—you’ll need knowledge to improve the system and get the results you want. It’s impossible to be a change agent without being a knowledge seeker first.

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