The Improvement Quotient

A Blog by NICHQ

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  • Three Projects Make Strides Towards Improving Child Health Systems

    Posted July 28, 2016 by Josh Grant

    At the outset of every project, we determine how it will relate to our three areas of focus—bridging health and healthcare, improving systems of care, and increasing support for healthy beginnings. Recently, three new projects have touched on these foundations, progressing towards improvements in systems for children’s health and outcomes for families.

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  • Closing the Gaps in Safe Sleep Education in Underserved Populations

    Posted July 26, 2016 by Elizabeth Barker

    While the country’s rate of sudden infant death syndrome (SIDS) has dropped by more than 50 percent over the past two decades, SIDS continues to claim the lives of about 1,500 U.S. infants each year. SIDS is the leading cause of death for infants and is highly correlated with unsafe sleep practices, which is why the Collaborative Improvement and Innovation Network to Reduce Infant Mortality (IM CoIIN) has made safe sleep practices one of its six focus areas. By helping to eliminate persistent but avoidable disparities in SIDS rates, addressing unsafe sleep practice with underserved populations can reduce infant mortality for all.

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  • Babies in Utero Experience Effects of National Opioid Addiction Epidemic

    Posted July 21, 2016 by Wendy Loveland

    Opioid abuse is at a crisis point in the U.S., and it’s affecting more and more babies in utero. Babies born to women who use opioids are cutoff from those drugs at birth, which puts the babies at risk for a cluster of neurological, gastrointestinal and respiratory symptoms that are collectively referred to as neonatal abstinence syndrome (NAS). Nationally, NAS has increased fivefold since 2000, and this rate, too, has become steeper in the past few years. In 2009, one infant was born with NAS per hour. By 2012, one baby was born with NAS every 25 minutes.

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  • Quality Improvement: A Necessary Addition to the Maternal and Child Health Tool Belt

    Posted July 19, 2016 by Avery Desrosiers

    MCH Practice Fellow Avery Desrosiers has been part of the IM CoIIN team during her time at NICHQ. Over the course of her work, she's learned about how quality improvement can affect maternal and child health, how encourages innovative changes within specific communities to improve health outcomes for vulnerable populations.

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  • Family Voices: Using Quality Improvement on the Family Level

    Posted July 14, 2016 by Josh Grant

    For families with children who have special healthcare needs, finding an optimal care system can sometimes be a challenge. While quality improvement is used a great deal in healthcare, a handful of parents participating in a NICHQ-led QI training are finding it can also help parents achieve their individual goals for improving as caregivers and their children’s quality of life. Shu-Chiung Chou recently participated in our ABC’s of QI course, offered to members of Family Voices, a national nonprofit organization working to achieve family-centered care. Chou was eager to join to learn how to better manage her daughter’s care and share what she learned with us.

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  • How Can Maternal Mental Health Be Improved During and After Pregnancy?

    Posted July 12, 2016 by Josh Grant

    Maternal mental health is a key part of moms’ and children’s health outcomes. According to the World Health Organization, 10 percent of pregnant women and 13 percent of postpartum women have mental health concerns, such as depression. Fortunately, these cases are largely treatable, especially if doctors are able to intervene early on.

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  • Improving Provider Education on Sickle Cell Solutions

    Posted July 06, 2016 by Elizabeth Barker

    For the estimated 100,000 Americans diagnosed with sickle cell disease (SCD), a medication called hydroxyurea (HU) can protect against pain outbreaks, lessen the need for blood transfusions and even reduce mortality. But while HU is the only drug approved by the FDA for preventing SCD-related complications, only 42 percent of adults with SCD were taking HU in 2014.

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  • How Can Men Be Engaged in Maternal and Child Health?

    Posted June 30, 2016 by Josh Grant

    The National Healthy Start Association's (NHSA) Where Dads Matter initiative helps engage men and dads in maternal and child health to help support health outcomes. NHSA President Kenn Harris recently spoke with us about Where Dads Matter, its impact and the role male caregivers play in MCH programs.

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  • 4 Benefits to Testing Before Implementing Changes

    Posted June 28, 2016 by Josh Grant

    Quality improvement means making long-term changes that can be adapted and sustained in different environments. Testing is one of the essential steps in optimizing a change idea so that it can improve a specific element within public health.

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  • How Sharing Data Can Help Cities and States Reduce Infant Mortality

    Posted June 23, 2016 by Josh Grant

    Data sharing is one of the most significant barriers between city and state health departments when it comes to reducing infant mortality. States and cities accumulate a great deal of data at various levels on birth outcomes and maternal care, but they don’t always make it readily available to each other.

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  • Innovations and Inspirations for Improving Children’s Health: June 2016

    Posted June 21, 2016 by Josh Grant

    Programs from healthcare providers, government agencies and other organizations help improve children's health by addressing new needs and closing gaps in care. This month, we've found innovative and inspirational examples touch on subjects like children's sleep during hospital stays and efforts to improve in-school care.

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  • NICHQ’s Sickle Cell Work Highlighted in Special Supplement to AJPM

    Posted June 16, 2016 by Cindy Hutter

    Two articles related to NICHQ’s portfolio of sickle cell projects are featured in a special sickle cell supplement of the American Journal of Preventive Medicine out today, in advance of World Sickle Cell Day June 19.

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  • Clinicians and Patients Work Together to Improve Preconception Health in the U.S.

    Posted June 14, 2016 by Sarah Verbiest, DrPH, MSW, MPH

    Fostering the creation of healthy families by choice, not chance, is not a new idea. Organizations and agencies are working to improve pregnancy planning, spacing and preventing unintended pregnancies. Given the high rates of unintended pregnancy in the U.S., action is needed from all stakeholders–consumers, health providers, policy makers–in proactively supporting this critical conversation.

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  • Leadership Engagement Bootcamp: Exercise 1: Understand Your Leader’s Style

    Posted June 09, 2016 by Josh Grant

    “Follow the Leader” isn’t always a game that should be played during quality improvement (QI) work. In fact, often, QI teams need to be proactive about engaging their leaders, creating a partnership to support change initiatives. To do that, leaders might have to be pushed out of their comfort zones.

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  • Ten Steps to Successful Breastfeeding Videos Showcase Strategies for Successful Implementation

    Posted June 07, 2016 by Cindy Hutter

    A new video series is showcasing how healthcare providers in Texas are successfully implementing the Ten Steps to Successful Breastfeeding, a set of evidence-based practices hospitals can follow to increase breastfeeding initiation and duration by new moms. Created by the Texas Department of State Health Services, this 10-video series features healthcare providers sharing their strategies for success on the pathway to improvement.

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  • Why Closing the Health Equity Divide Can’t Wait Any Longer

    Posted June 01, 2016 by Cindy Hutter

    With the projection that more than half of the nation’s children will be part of a minority race or ethnic group by 2020, the need to address health equity has never been stronger.Equity in healthcare is the idea that everyone has the same access to quality care, regardless of social, economic, demographic or geographical differences. This ideal is not a current reality in the U.S. healthcare system. There are many barriers hampering health equity and the overall health of America’s children.

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  • NYS Breastfeeding Collaborative Welcomes New Hospitals

    Posted May 26, 2016 by Josh Grant

    More mothers in New York will soon experience better improvements in hospital maternity care, as 21 more hospitals join the state’s Breastfeeding Quality Improvement in Hospitals Collaborative (BQIH). Cohort A saw 12 New York hospitals work together and use quality improvement (QI) methods to change their systems and practices to better support a mothers choice to breastfeedings. Cohort B will see 20 new hospitals participate in the collaborative, building off the momentum and learnings from their predecessors.

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  • Medicaid Strategies to Promote Increased Access to Long-Acting Reversible Contraception (LARC)

    Posted May 24, 2016 by Tamara Kramer; Karen VanLandeghem, MPH

    Unplanned pregnancies can present a tremendous challenge for many women, healthcare payers and the community, and are associated with a number of negative health outcomes, such as delayed prenatal care and premature births. Efforts like the Centers for Medicare and Medicaid Services’ (CMS) recent guidance and the Collaborative Improvement & Innovation Network to Reduce Infant Mortality (IM CoIIN) have improved maternal and infant health outcomes, while also highlighting the $10 billion cost burden Medicaid expends on unplanned births.

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  • Innovations and Inspirations for Improving Children’s Health: May 2016

    Posted May 19, 2016 by Josh Grant

    Across the United States, organizations and government agencies are creating new approaches to improve children’s health. Because we support innovation for helping children lead healthier lives, we’ve highlighted some of the most exciting initiatives we’ve seen in the last few weeks. Read on to learn how some groups are addressing critical health needs.

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  • Putting the Cross-Sector Gears in Motion: How 3 Best Babies Zones Are Moving Towards Cross-Sector Action to Reduce Disparities in Infant Mortality

    Posted May 17, 2016 by Monica Barr

    The Best Babies Zone (BBZ) Initiative has been working on the social determinants of health for four years. In 2012, BBZ was launched to address the social, economic and environmental factors that contribute to poor birth outcomes. With funding from the W.K. Kellogg Foundation, three small pilot “zones” were launched in Cincinnati, OH, New Orleans, LA, and Oakland, CA. In these cities, a lead organization connects and convenes partners from across sectors, creating possibilities for innovative projects that address the root causes of infant mortality in that community.

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  • Boxing Out Unsafe Sleep Practices for Babies

    Posted May 10, 2016 by Josh Grant

    In the 1930s, Finland’s infant mortality rate reached 65 deaths per 1,000 live births, leading to the 1938 introduction of baby boxes—kits that include a mattress, bedding, diapers, a box that serves as a crib and other necessities. By 2015, that rate had dwindled to an estimated 2.52 deaths per 1,000 live births. In 2014, there were 3,500 sudden unexpected infant deaths in the United States, 25 percent of which were caused by accidental suffocation or strangulation in bed. Learning from Finland’s success, organizations in the U.S. are beginning to offer their own baby boxes to new families.

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  • Rhode Island Targets Social Factors to Achieve Health Equity

    Posted May 05, 2016 by Rachel Kremen

    While a higher percentage of Rhode Islanders have health insurance compared to the U.S. average, achieving health equity has been a challenge for the state—especially for its infant mortality rate. Now, the Rhode Island Department of Health is targeting key social factors that impact infant mortality in minority groups, including education, income and stress. The Rhode Island Commission for Health Advocacy and Equity was created in 2011 to address the inequity, by bringing together state agencies to focus on the social determinants of health—typically defined as the wider set of forces and systems shaping the conditions of daily life. Aligning the efforts of those inside and outside the state is also key.

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  • Medicaid Strategies to Promote Full-Term Births

    Posted May 03, 2016 by Tamara Kramer

    Reducing the rate of pre-term birth is a major priority for state health agencies and a growing concern for state Medicaid programs. Medicaid agencies provide coverage for over half of the nation’s births each year and pay for a higher rate of premature or low-birth weight babies than the private insurance market (10.4 percent versus 9.1 percent). Pre-term birth, a birth that occurs prior to 37 weeks of gestation, is the leading cause of infant mortality in the United States. Early delivery is associated with a host of long-term health issues for the infant, including sight and hearing loss, cerebral palsy and developmental and intellectual disabilities.

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  • Rooming-in: An Essential Evolution in American Maternity Care

    Posted April 28, 2016 by Jennifer Ustianov, MS, BSN, RN, IBCLC

    Over the past few years, many U.S. hospitals have moved away from the traditional use of nurseries for healthy newborn infants, choosing to move toward rooming-in and couplet care. Rooming-in is an evidence-based practice that promotes keeping healthy newborn babies and their mothers together in post-labor recovery rooms. This recent change in practice and policy for many hospitals is partially based on recommendations in the World Health Organization’s (WHO) Ten Steps to Successful Breastfeeding and the increased movement toward earning Baby-Friendly designation in the U.S.

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  • Why I Participate: By Parent Partner Ivette Torres

    Posted April 26, 2016 by Ivette Torres

    Ivette Torres shares why proper support is key for positive breastfeeding outcomes and how her experiences led her to join the Texas Ten Step Star Achiever Breastfeeding Learning Collaborative as a parent partner.

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  • A New Primer for PCPs on Starting a Healthy Weight Clinic

    Posted April 21, 2016 by Josh Grant

    Developed as part of the Mass in Motion Kids Learning Collaborative, NICHQ’s new Healthy Weight Clinic Guide teaches providers how they can develop, implement and maintain community-based pediatric healthy weight clinics. The Healthy Weight Clinic Guide is an opportunity for healthcare providers, families and children to address obesity together and promote healthy living.

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  • Using Telementoring to Improve Care for Patients With Sickle Cell Disease

    Posted April 19, 2016 by Sonya Spillmann, RN

    In the United States, nearly 100,000 people have the inherited red blood cell disorder sickle cell disease (SCD), yet access to knowledgeable providers throughout their lifespan is one of the biggest challenges for these patients. With a desire to narrow this disparity, groups of SCD experts are teaching healthcare providers how to capably manage patients with SCD by harnessing the power of technology, including telementoring.

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  • Recommendations for Promoting Young Children’s Socioemotional Development in Primary Care

    Posted April 14, 2016 by Cindy Hutter

    Early childhood is a critical window of opportunity for promoting early socioemotional health. When children's socioemotional health (defined as a child’s capacity to form secure relationships, experience and regulate emotions and explore and learn) is compromised, it can have significant implications on long-term wellness including failure in school, inability to make or sustain friendships, and poor self-image. Through a project called Promoting Optimal Child Development, NICHQ, along with Ariadne Labs and the Einhorn Family Charitable Trust (EFCT), worked together to develop recommendations for using pediatric primary care practices to reinforce positive socioemotional behaviors in primary caregivers of children ages 0 to 3.

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  • ABCs of Safe Sleep Education Reduces Sleep-Related Infant Deaths in Tennessee

    Posted April 12, 2016 by Cindy Hutter

    Through a multi-faceted statewide campaign, which includes teaching new parents and hospital staff the ABCs of safe sleep practices, Tennessee has seen a 25 percent reduction in sleep-related infant deaths since 2014. Tennessee’s successful safe sleep strategy has focused on teaching and modeling safe sleep behaviors—both in the hospital setting and directly with parents—using the primary message, “Remember the ABCs of Safe Sleep.”

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  • Trends in Sickle Cell Disease Focus on Therapeutic Treatments, Care Transitions and Global Health

    Posted April 07, 2016 by Cindy Hutter

    Since NICHQ was named the National Coordinating Center for the Sickle Cell Disease Treatment Demonstration Program (SCDTDP) in 2010 there have been increases in the number of providers prescribing disease modifying therapies, such as hydroxyurea to treat patients with sickle cell disease (SCD), better care in emergency departments, along with increases in the number of patients receiving regular care with providers knowledgeable about treating SCD. As the project enters into a new phase, we recently sat down with Suzette Oyeku, MD, MPH, medical director for NICHQ’s sickle cell work to learn more about the project’s evolution and learnings.

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  • Delaware Hones in on Medical-Legal Partnerships to Reduce Infant Mortality

    Posted April 05, 2016 by Wendy Loveland

    A pregnant woman living in poverty faces stress that often has negative consequences for her and her baby’s health, including infant mortality. Unmet housing needs, lack of access to quality healthcare, financial insecurity, immigration status and family stability are just some of the social determinants of health affecting pregnant women. Many of these stressful situations require legal aid, but healthcare and the law have historically worked separately. The Delaware team participating in the Collaborative Improvement and Innovation Network to Reduce Infant Mortality (IM CoIIN), led by NICHQ, is working to develop medical-legal partnerships (MLPs) to address these stressors in an integrated way and improve health outcomes for women and babies.

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  • Why I Participate: By Parent Partner Mercédez Cahue

    Posted March 31, 2016 by Mercédez Cahue

    Mercédez Cahue shares her breastfeeding experience and why she joined the Texas Ten Step Star Achiever Breastfeeding Learning Collaborative as a parent partner.

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  • Just Download It: Wyoming Discovers Novel Way to Help Pregnant Mothers

    Posted March 29, 2016 by Cindy Hutter

    Wyoming is improving its birth outcomes one downloader at a time. An interactive mobile app—Due Date Plus—that the state Medicaid office developed for pregnant women is redefining prenatal education and transforming how Medicaid meets the needs of its pregnant population.

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  • Focusing on Population-Level, Collaborative, Perinatal Outcomes Improvement

    Posted March 24, 2016 by Ed Donovan

    It is becoming increasingly clear that efforts to improve risk-appropriate site of delivery may benefit from close collaboration among perinatal care providers, payers and public health organizations. State health departments and state hospital associations often manage repositories of population-level perinatal data while perinatal quality collaboratives can engage front-line providers. Collaborative partnerships among these entities can facilitate improved outcomes at the population level.

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  • Healthy Weight Initiative Thrives By Focusing on Healthy Lifestyles, Not Weight

    Posted March 22, 2016 by Cindy Hutter

    Through a Healthy Weight Initiative at the Greater New Bedford Community Health Center, well over 200 kids have learned about monitoring sleep routines, fruit and veggie intake, screen time, physical activity and sweetened beverages. It’s a focus on healthier lifestyles and better choices, not weight loss, which is helping kids and families to see results.

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  • 6 Tips for Encouraging Pilot Sites to Collect Data

    Posted March 17, 2016 by Cindy Hutter

    Engaging pilot sites to test out change ideas and collect data is one of the best ways to learn how to make change at a local level. Pilot sites can test ideas and assist with planning and implementing a project “on the ground” with individuals in a project’s target audience. If pilot sites are challenged around collecting data to drive their improvement efforts, here are six tips to support them.

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  • Best Practices for Inclusion of Men and Dads in Children’s Health

    Posted March 15, 2016 by Josh Grant

    Children greatly benefit from having active paternal figures in their lives. According to the State of the World’s Fathers report, it leads to improved mental health in children, higher immunization rates and support for women who are breastfeeding. The creation and availability of educational resources that encourage male involvement are crucial to achieving that. Knowing this, the California WIC Association (CWA) created "Engaging Men & Dads at WIC: A Toolkit" to help the local WIC (Women, Infants and Children Supplemental Nutrition Program) organizations better connect with dads.

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  • Better Care for High-Risk Babies: Improving Perinatal Regionalization in Illinois

    Posted March 10, 2016 by Elizabeth Baker

    An ongoing effort from the Illinois team involved in the Collaborative Improvement and Innovation Network to Reduce Infant Mortality (IM CoIIN) is to get 90 percent of very preterm infants in Illinois delivered in Level 3 perinatal facilities. These facilities feature neonatal intensive care units (NICUs), where a combination of leading-edge technology and specially trained staff can vastly improve health outcomes for high-risk babies.

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  • WIC Reps Bridge Gap Between Community and Hospitals through Breastfeeding Support

    Posted March 08, 2016 by Sonya Spillmann, RN

    With both large urban and rural areas in Texas, sharing consistent and accurate information about the benefits of breastfeeding with mothers and healthcare workers is an enormous undertaking. One statewide initiative, the Texas Ten Step Star Achiever Breastfeeding Learning Collaborative, is harnessing the power of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) staff, using them as conduits for communicating evidence-based practices and offering guidance to both mothers and healthcare providers.

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  • 4 Strategies for Building a Public Health Social Movement

    Posted March 03, 2016 by Cindy Hutter

    Forget the old marketing tactic of shouting loud and often. Mario Drummonds, MS, LCSW, MBA, the CEO of Strategy Interactions, and a participant in the NICHQ-led Collaborative Improvement and Innovation Network to Reduce Infant Mortality (IM CoIIN), shares four strategies for building a public health social movement to increase state and national attention on your healthcare issue.

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  • South Carolina Finds Winning Strategy to Reducing Unintended Pregnancies in its Medicaid Population

    Posted March 01, 2016 by Wendy Loveland

    In South Carolina, half of all pregnancies in 2010 were unintended, primarily due to either lack of or failed contraceptives. Within the South Carolina Medicaid population, almost 79 percent of women defined their pregnancy as unintended. This is particularly troubling because births resulting from unintended pregnancies are linked to adverse maternal and child health outcomes and myriad social and economic challenges. To reduce this percentage, South Carolina Medicaid began a policy change in 2012 aimed at increasing the use of immediate postpartum inpatient insertions of long-acting, reversible contraceptives (LARCs).

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  • NICHQ's Internal PTF Model Proves a ‘Promising Practice’ in Medical Home Transformation

    Posted February 25, 2016 by Cindy Hutter

    The National Center for Medical Home Implementation has named NICHQ’s CHIPRA Massachusetts Medical Home Initiative an “innovative and promising practice” in pediatric medical home implementation. The initiative focused on helping 13 pediatric practices in Massachusetts successfully implement a medical home model of care. Unique to the project was the use of an internal practice transformation facilitator (PTF)—a motivated individual currently employed within the practice—to manage the day-to-day implementation needs of the pediatric medical home transformation.

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  • Second-Time Moms Appreciate Hospital Changes to Support Breastfeeding

    Posted February 23, 2016 by Rachel Kremen

    When Nicole Acosta delivered her first child in May 2013, she knew she wanted to breastfeed, but she didn’t get as much support as she’d expected at her hospital, Good Samaritan Medical Center in West Islip, NY. Despite an uncomplicated delivery, no one suggested immediate skin-to-skin contact—a practice known to increase the likelihood of breastfeeding success. By the time she had her second son in June 2015, things had certainly changed at the hospital.

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  • New CDC Data Shows More Work Needed to Curb Smoking During Pregnancy

    Posted February 19, 2016 by Sabrina Selk

    It has been more than 50 years since the Surgeon General’s report on the adverse health impacts of smoking. However, maternal smoking during pregnancy remains a persistent problem that healthcare and public health professionals have been unable to eliminate.

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  • NYS Hospitals See Dramatic Results in Breastfeeding Collaborative

    Posted February 17, 2016 by Cindy Hutter

    Recruitment is open for hospitals in New York State to join the state’s Breastfeeding Quality Improvement in Hospitals (BQIH) Learning Collaborative. If the results of the predecessor cohort of hospitals is any indication, these new recruits are in for some big changes.

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  • How Kansas is Leveraging the Infant Mortality CoIIN to Accelerate Improvement

    Posted February 11, 2016 by Cindy Hutter

    Collaborative Improvement and Innovation Networks (CoIINs) offer many tools and resources for their participants. From driver diagrams to measurement strategies to change packages and collaboration tools, the underlying supports for accelerating change are all there. A participant just needs to reach out and embrace them.

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  • The Long-Term Value of Better Breastfeeding Support

    Posted February 09, 2016 by Liz Barker

    For hospitals and patients alike, the benefits of boosting breastfeeding support last far beyond any hospital stay. Investing in improved maternity practices can lead to major quality gains, jumps in patient satisfaction, and slashed healthcare costs—not to mention its power to drive up breastfeeding rates and protect the health of both moms and babies.

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  • The Value of Increasing Exclusive Breastfeeding along the Texas-Mexico Border

    Posted February 04, 2016 by Wendy Loveland

    A baseline report shows that only 15 percent of infants born in South Texas (Health Service Region 11) in 2009 were exclusively breastfed on their second day of life compared to 42 percent of infants in Texas overall, and as many as 55 percent in other parts of the state. An increase in exclusive breastfeeding in the Valley could not only increase the state’s overall rate, but could provide a roadmap for other similar communities to follow to improve the health of their residents.

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  • 3 Tips for Transforming Data Into Visuals That Tell A Clear Story

    Posted February 02, 2016 by Julius Anastasio

    A big part of gaining buy-in, enabling change, or effectively explaining progress depends on how we convey the data we’ve been collecting, and the story we tell about it. So while data collection and analysis can be hard, effective data presentation is even harder.

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  • Protecting Babies From Sleep-Related Deaths Starts With Painting a Clear Picture

    Posted January 28, 2016 by Cindy Hutter

    Today’s parents and parents-to-be rely a great deal on the Internet, print and broadcast media to inform their childcare and parenting practices. Yet in a recent study of magazines targeting women of child-bearing age, more than one-third of images showed babies in unsafe sleep positions (e.g., on their stomachs) and more than two-thirds showed babies in unsafe sleep environments (e.g., in a crib with blankets). Thousands of precious lives could be saved each year if every parent and caregiver had a clear picture of what it takes to protect their babies during sleep.

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  • Join Interactive Webinar on Improving the Health of New Mothers

    Posted January 26, 2016 by Cindy Hutter

    NICHQ, along with partners AMCHP and the UNC Center for Maternal and Infant Health, is turning the session “Improving the Health of New Mothers: Building Woman‐Centered Postpartum Systems of Care” into a free public webinar. We invite you to join us on Feb. 2, from 3:30-5 p.m. ET

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  • Tips for Sustaining Leadership Involvement in Your QI Project

    Posted January 22, 2016 by Cindy Hutter

    When it comes to sustaining change, many of the critical elements required in leading change—creating urgency, having a vision and strategy, removing obstacles, solidifying gains—are all still required. But one key element to make sure change sticks and gets anchored to a culture is to nurture a coalition of formal and informal leaders that support the ongoing improvement effort.

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  • Moms Deserve Better Care In The Fourth Trimester

    Posted January 20, 2016 by Alison Stuebe

    In the weeks following childbirth, mothers must adapt to plunging hormones, recover from birth and learn how to feed and care for a new infant. Amid these challenges, moms receive minimal support from the healthcare system. Postpartum visits are typically scheduled four to six weeks after birth, leaving moms to cope on their own for more than a month. Moms need more support in the weeks following birth.

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  • How and Why to Support a Culture of Patient Partnership Across the Care Spectrum

    Posted January 14, 2016 by Tara Bristol Rouse

    More and more there is emphasis on partnering with patients and families to improve the quality and safety of healthcare. We advocate for the use of patient/family advisory councils and patient/family partners on improvement committees but, most often, we talk about these interventions in the acute care or chronic care environment. What we miss a fair share of the time is putting an emphasis on promoting partnerships during the everyday well-visit and sick-visit interactions—the same visits that have the potential to build and support a culture of partnership and engagement across the care spectrum!

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  • I'm a Coach, But You Have the Answers

    Posted January 12, 2016 by Elaine Fitzgerald, DrPH, MIA

    Coaching isn’t just ingrained in me, it’s ingrained in NICHQ. As we work with partners and team members at every level, we aim to be a coach that provides guidance and builds confidence. We offer best practices and support teams to think about sustainable approaches for applying, adapting and testing those ideas within their own settings and communities.

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  • 5 Tips for Testing to Optimize Your Next PDSA

    Posted January 06, 2016 by Cindy Hutter

    The Plan-Do-Study-Act (PDSA) cycle is a fundamental tool in the quality improvement tool belt. PDSA cycles are used to test, implement and spread change ideas in a systematic way. Regardless of your improvement framework—collective impact, the breakthrough series, etc.—PDSAs can be used.

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  • Supporting Breastfeeding Across A Hospital System

    Posted January 04, 2016 by Wendy Loveland

    Changing a habit is not easy, even when you know it is “good for you.” The same goes for changing healthcare systems. The benefits of breastfeeding are well known, and supported by the World Health Organization, the Joint Commission, and many other healthcare accreditation and oversight agencies and experts. However, many hospitals struggle to create environments that support mothers who choose to breastfeed.

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  • Managing Life Stressors Helps to Reduce Infant Mortality

    Posted September 29, 2015 by Wendy Loveland

    Participants in the Collaborative Improvement and Innovation Network to Reduce Infant Mortality (IM CoIIN) are working to reduce the U.S.’s infant mortality rate and improve birth outcomes. By addressing the underlying causes of infant mortality, in particular, stress, teams hope to reduce infant deaths overall, as well as close the disparity gap between white and black babies.

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  • Why Applying Quality Improvement Techniques to Non-clinical Data Makes Sense

    Posted September 25, 2015 by Sabrina Selk

    The growing trend of increasing capacity and timeliness of collecting surveillance data (such as birth and death records used by epidemiologists) is opening up opportunities for these rich data sources to be used for quality improvement (QI) efforts.

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  • Diaper Vouchers Add Extra Incentive for Pregnant Women to Quit Smoking

    Posted September 22, 2015 by Cindy Hutter

    It is not exactly cold hard cash, but don’t poo poo it. Free diapers are enough of an incentive to encourage pregnant women to quit smoking and stay quit.

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  • 4 Steps for Starting a Patient and Family Advisory Council

    Posted September 18, 2015 by Cindy Hutter

    While it takes time, energy and commitment to build and maintain a patient and family advisory council (PFAC), getting started is straightforward. Just follow these four steps from the Creating a Patient and Family Advisory Council: A Toolkit for Pediatric Practices:

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  • Prenatal to Postpartum Continuum of Care Provides Benefits for Mothers Choosing to Breastfeed

    Posted September 15, 2015 by Cindy Hutter

    Educating mothers about the benefits of breastfeeding before they enter the hospital increases the likelihood mothers will choose the beneficial feeding method. However, building bridges between care providers, community groups and hospitals can be surprisingly difficult. One community participating in the New York State Breastfeeding Quality Improvement in Hospitals (BQIH) Learning Collaborative has figured it out.

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  • A Practical Approach to Keep Stakeholders Engaged

    Posted September 10, 2015 by Cindy Hutter

    When it comes to building and maintaining support for its ongoing infant mortality reduction efforts, the Wisconsin Division of Public Health has a practical solution: repackage and re-share. Factsheets are helping Wisconsin build and maintain support for their infant health work.

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  • Inspiring Change through Motivational Interviewing

    Posted September 08, 2015 by Rachel Kremen

    Helping people make a long-term, healthy lifestyle choice doesn’t have to be daunting. The key lies in motivating—not indoctrinating—the client. Motivational interviewing is a style of communication for helping someone explore and resolve their ambivalence to change.

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  • Addressing Infant Health Disparities in the American Indian Population Starts by Building Trust with Tribes

    Posted September 03, 2015 by Rachel Kremen

    Native Americans have rich traditions and beliefs that often conflict with Western healthcare culture. To address disparities in infant health in this vulnerable population, experts say public health and healthcare workers need to build relationships first, then offer advice second.

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  • Resources and Must Reads for Infant Mortality Awareness and Sickle Cell Awareness Month

    Posted September 01, 2015 by NICHQ

    NICHQ is joining with organizations around the country and world to celebrate Infant Mortality Awareness Month and National Sickle Cell Awareness Month in September. NICHQ has a long history of working to improve outcomes on these health topics. We invite you to explore and share our resources, stories, videos and other materials related to reducing infant mortality rates and improving care for individuals with sickle cell disease.

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  • Why and How to Include the Patient-Family Voice in a Medical Home

    Posted December 23, 2014 by Bonnie Thompson, Mass Family Voices

    As more primary care practices work towards identifying themselves as a medical home, patients and family caregivers can play a vital role in shaping how healthcare is delivered.

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  • Find Success and Mirror It - Can It Be That Simple?

    Posted December 12, 2014 by Elissa Faro, PhD

    Childhood malnutrition. Infant mortality. Childhood obesity. Health inequalities and disparities. These are just some of the most demanding problems facing those who work to improve child health. However, these big issues are often seemingly intractable. How do you move the needle when previous efforts have yielded such meager results? One answer may lie in the concept of positive deviance.

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  • Managing the Universe of Special Healthcare Needs

    Posted November 17, 2014 by Katrina McCarty, MPA

    A vast universe of symptoms, medications, complications, specialists and tests constantly surround my friend Julie. She is 38 and has Type 1 diabetes (T1D), which she was diagnosed with at age 10. Her quest for a long and prosperous future of good health is both harrowing and inspiring.

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  • Incorporating Quality Improvement in Public Health

    Posted November 11, 2014 by Lloyd Provost, MS

    From my recent experience at the Infant Mortality Summits, a meeting of the Collaborative Improvement and Innovation Network (CoIIN) to Reduce Infant Mortality, it seems that the time is ripe for the widespread growth of quality improvement (QI) strategies in the public health arena.

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  • Contradicting Assumptions About Infant Mortality Rates: How Far Upstream?

    Posted November 04, 2014 by Charles J. Homer, MD, MPH

    Learning often begins when facts contradict our assumptions. While attending the kickoff summits of the Collaborative Improvement and Innovation Network (CoIIN) to Reduce Infant Mortality in July, I became aware of at least two facts that contradicted my previous assumptions: (1) that infant mortality rates for non-Hispanic blacks are higher in the upper Midwestern states than they are in the deep South and (2) that the declines in infant mortality in several southern states over the past decade have been steeper than anywhere else in the country.

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  • Patient Engagement, Partnerships and Puppies

    Posted October 27, 2014 by Tom Dahlborg, MSM

    I was recently invited to host the World Congress Patient Engagement Summit in Boston. The event promised to “leave behind theory and bring about actionable change with actionable solutions to engage patients and move the needle on clinical outcomes and community health.” And, it lived up to this billing.

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  • Stories Matter

    Posted October 20, 2014 by Marianne McPherson, PhD, MS

    In previous blog posts, I’ve often featured a children’s story as the jumping off point for my message. This time, “story” is the message.

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  • Improvements in Maternity Care Practice Are Not Easy

    Posted September 22, 2014 by Lori Feldman-Winter, MD, MPH

    As NICHQ’s faculty chair for Best Fed Beginnings, a national initiative that supports hospitals seeking Baby-Friendly designation, I am frequently exposed to pushback regarding the improvements required for a hospital to achieve this designation. Recently, an article published in the Washington Post portrayed Baby-Friendly practices as a problematic set of policies that “force” a new mother to breastfeed against her wishes. Nothing could be farther from the truth.

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  • Living the Life of a Sickle Cell Warrior

    Posted September 15, 2014 by Fatima Oyeku

    In support of National Sickle Cell Awareness Month, NICHQ invited Fatima Oyeku, a woman living with sickle cell disease, to share her perspective. “Maybe I'm just being overly optimistic, but I honestly think SCD could be eradicated if more people knew their trait status and have the opportunity to make an informed decision about having children,” she says.

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  • Why I Struggled to Find My Breastfeeding North Star

    Posted August 27, 2014 by Katrina McCarty, MPA

    As a new mom, I found myself searching for a true guiding presence as I tried to make decisions about caring for my daughter and myself. I knew I wanted to breastfeed her and I assumed it would be easy. I assumed the stars would align and she and I would be deliriously connected and she would be nourished. I assumed a hungry baby and a food source were enough. Not quite.

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  • A Busy Summer: Building Blocks, Babies and Breastfeeding

    Posted August 15, 2014 by Meghan Johnson, MSc

    August is typically a month for relaxing, vacationing and taking long weekends to enjoy the warm weather. At NICHQ, we get our share of R & R, but August 2014 is also a particularly busy and exciting time! In August, we celebrate National Breastfeeding Month and World Breastfeeding Week (August 1-7), and as part of that, I am excited to help launch NICHQ’s new breastfeeding project with the New York State Department of Health.

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  • Communicate, Collaborate and Innovate to Reduce Infant Mortality

    Posted July 02, 2014 by Peter Gloor, PhD

    Compared to other Western countries, infant mortality in the US is shockingly high. High infant mortality is a social problem that can only be solved through massive collaboration and out-of-the-box innovation.

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  • Overcoming the Epidemic of Compassion Fatigue

    Posted June 05, 2014 by Lauren Smith, MD, MPH

    Given the many priorities and important issues that are competing for our collective attention, how do we break through the cacophony of dire statistics and grave warnings about so many “epidemics?"

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  • Let the Wild Rumpus Start! Your Ideas Wanted!

    Posted May 16, 2014 by Marianne McPherson, PhD, MS

    There’s no time like the present. We're collecting your wildest, craziest ideas for how we might improve children’s health together.

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  • Collective Impact: Coloring a New Vision of Collaboration

    Posted May 07, 2014 by Marianne McPherson, PhD, MS

    The concept of collective impact is in NICHQ's DNA. All of our work is in some way about bring together participants from difference sectors committed to a common agenda to solve complex social problems. Until recently, we didn't have the benefit of the language or framework.

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  • 10 Steps for Benching Bullying

    Posted April 22, 2014 by Tom Dahlborg, MSM

    There are many broader influences that affect children’s health outside of the clinical setting. This certainly includes the bullying that happens on our ball fields that can lead to physical injury, social problems, emotional problems, mental health problems (e.g., depression, anxiety), and even death. Not to mention bullying can turn children off from physical activities and this can potentially lead to obesity. As an organization that aims for all children to achieve their optimal health, there is much work to be done…together.

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  • What's in a Name

    Posted April 14, 2014 by Charlie Homer

    To more accurately reflect our purpose, we are making a change in our name, from “healthcare” to “health.” NICHQ’s purpose has always been to improve children’s health. That is our passion and now our name is aligned.

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  • Breaking the Food Reward Chain

    Posted March 20, 2014 by Cindy Hutter, MBA

    If we really want to improve children’s health, we need to focus not just on improving the quality of care children receive when they go to the doctor’s office; we need to change all influences that affect a child’s health. This includes modeling and practicing healthy behaviors at home, in school and in the community.

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  • Life Lessons from a First Grade Teacher

    Posted March 18, 2014 by Jonathan Small, MBA

    Many years later, the life lessons I learned from my son's first-grade teacher in 1998 are still profoundly influential, especially when viewed through the lens of quality improvement, a framework I learned later in life.

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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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  • Have We Turned the Tide on Childhood Obesity?

    Posted March 04, 2014 by Shikha Anand, MD, MPH

    If you’ve read anything about obesity in the lay press over the past week, you already know that there has been a decline in the prevalence of obesity in American preschoolers.This news is both exhilarating and anxiety provoking. Celebrating too early could distract from the fact that there is so much more work to be done, especially for our most vulnerable children.

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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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  • Systems Level Healthcare Improvement Starts with Individual Relationships

    Posted February 24, 2014 by Tom Dahlborg, MSM

    Want to improve the healthcare system from a systems perspective? Develop systems which allow for time, continuity, relationship, trust, authentic sharing, the telling and hearing of the patient’s whole story at each healthcare encounter. Create system change which positions clinicians to use tools such as emotional intelligence and motivational interviewing to ensure optimal sharing and comprehension.

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  • Taking a Bite Out of Mixed Food Messaging

    Posted February 20, 2014 by Cindy Hutter, MBA

    When I first saw McDonald’s Olympic themed advertising that shows Olympians biting their metals contrasted with good looking, fit, young adults biting into chicken nuggets with the tagline, “The greatest victories are celebrated with a bite,” the marketing professional in me thought that was very clever. The parent and healthcare professional in me were horrified.

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  • What Rosie Revere, Engineer Teaches Me About Innovation

    Posted February 19, 2014 by Marianne McPherson, PhD, MS

    I’ve been thinking about innovation a lot lately, in large part due to a renewed commitment at NICHQ to be a hub for creating and spreading innovations. I am so excited about this commitment because I know that new ideas and new approaches—and building them together—will help create a world in which all children achieve their optimal health.

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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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  • Bravo CVS! Now It’s Time for More Health Advocates (You) to Step Up

    Posted February 05, 2014 by Cindy Hutter, MBA

    Just as peer pressure is what gets many young people to start smoking, peer pressure is what it is going to take to get other cigarette retailers to stop. Let’s start loading on the pressure.

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  • What I Learned About Physician Autonomy at the ATM Machine

    Posted January 13, 2014 by Shikha Anand, MD, MPH

    Now that I have the opportunity to work for a quality improvement organization with a vision of ensuring each child achieves his or her optimal health, and to process this information through the lens of my own experiences (personal and professional), my heart still breaks for those children harmed by bullying…AND I see great opportunities for improvement.

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  • Improvement - A Philosophy to Live By

    Posted January 11, 2014 by Meghan Johnson, MSc

    For as long as I can remember, I have been working to make things more organized, effective and efficient. I have spent countless hours organizing and reorganizing things in my life – everything from my son’s toys and games to the storage of our digital photos. It shouldn’t be surprising, then, that I have spent over a decade in project management and just over a year ago, found my way to NICHQ and discovered quality improvement science.

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  • Beyond Bullying

    Posted January 10, 2014 by Tom Dahlborg, MSM

    Now that I have the opportunity to work for a quality improvement organization with a vision of ensuring each child achieves his or her optimal health, and to process this information through the lens of my own experiences (personal and professional), my heart still breaks for those children harmed by bullying…AND I see great opportunities for improvement.

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  • When Did Breastfeeding Become a Choice?

    Posted January 09, 2014 by Jennifer Ustianov, RN, BSN, IBCLC

    I know the tides are beginning to turn. Recent reports show breastfeeding rates are increasing in the US. The journey back to a more supportive breastfeeding culture has begun in this country. But I wonder whether there is more we can do to accelerate this process, so that from this generation forward there is no question and no need to choose.

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  • Like Halloween Every Day

    Posted January 08, 2014 by Rachel Sachs Steele, MEd

    I love Halloween. For one day every year, I get to try something new, look totally silly, celebrate fear and play with possibilities, all without the usual external or internal constraints. Can you imagine what life would be like if we had that freedom all the time?

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  • An Improvement Wake-Up Call

    Posted January 07, 2014 by Jonathan Small, MBA

    It never ceases to amaze me what I learn from my children, especially the youngest ones – my eight-year-old twin daughters. I’ve been working in the quality improvement field for longer than they’ve been alive. But now they’re the ones teaching me about it!

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  • Removing the Burden of Care Coordination

    Posted January 06, 2014 by Cindy Hutter, MBA

    I had never heard of the concept of a medical home before coming to NICHQ, but I’ve now seen what is possible in a patient-focused system where primary care physicians and specialists coordinate to deliver high-quality healthcare. In situations like mine, where there are no established protocols to follow, the need for a medical home is most critical—and paradoxically, most lacking.

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