The Improvement Quotient

A Blog by NICHQ

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  • Knowing What to Do for Sickle Cell Patients Is Not Enough

    Posted November 30, 2015 by Elissa Faro, PhD

    Sometimes, even when we have guidelines and evidence-based practices to improve care and outcomes for individuals with sickle cell disease, it isn’t always enough.

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  • A Grocery Store on Wheels

    Posted November 24, 2015 by Cindy Hutter

    Nearly 23.5 million Americans are living in neighborhoods without convenient options for buying fresh and affordable food. This is a serious public health problem because the health of a community depends on access to healthy foods. Josh Trautwein decided to tackle the “grocery gap” in Boston by creating the nonprofit Fresh Truck. The idea behind Fresh Truck is simple—become a reliable source of healthy food in neighborhoods that lack convenient access to grocery stores

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  • States Use Home Visiting Programs to Spread Safe Sleep Messages

    Posted November 18, 2015 by Cindy Hutter

    The growing demand for maternal and child health services and support, coupled with stagnant or shrinking resources, is causing state health departments to find creative ways to do more with less. Many states are leveraging home visiting programs as a convenient way to spread important information and strategies related to safe sleep practices, a key component of infant mortality reduction efforts.

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  • Being Small Has Advantages for Hospitals Implementing the Ten Steps

    Posted November 13, 2015 by Cindy Hutter

    Turns out, size may not matter. Small rural hospitals in New York State are experiencing as much, if not more, success in implementing evidenced-based practices to improve maternity care practices as their bigger suburban and urban counterparts.

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  • Battling Prematurity to Ensure a Fighting Chance for Every Baby

    Posted November 10, 2015 by March of Dimes

    Every year, about 380,000 babies are born too soon in the United States. Our preterm birth rate of 9.6 percent places the U.S. among the worst of high resource nations. Preterm birth is the leading cause of newborn death and babies who survive an early birth often face serious and lifelong health problems. November is the time to focus the spotlight on the problem of prematurity during Prematurity Awareness Month and World Prematurity Day Nov. 17.

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  • Bringing the APHA Poster Session to You

    Posted November 05, 2015 by Cindy Hutter

    NICHQ staff members were thrilled to see so many familiar faces at the American Public Health Association Annual Meeting in Chicago earlier this week. The meeting’s theme was “Health in All Policies.” We couldn’t agree more that the environments in which people learn, live, play and work have a tremendous impact on their health.

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  • 5 Reasons Why Evaluation Matters to Your Project

    Posted November 03, 2015 by Rachel Levine

    As a Senior Analyst at NICHQ, I’m a huge proponent of evaluation. The reason is simple: projects may sound compelling and seem worthwhile, but it is hard to know if they actually achieve their goals without collecting data and conducting an evaluation. Evaluation data provides a window into whether, why and how programs achieve their goals. Evaluation is also essential to ensure that limited resources are utilized most efficiently for the greatest possible impact. Still need convincing? Here are five reasons why evaluation matters to your project and how to get it done.

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  • Candy Trade-In Spurs Healthy Living

    Posted October 30, 2015 by Cindy Hutter

    This is the first year my daughter truly “gets” Halloween. Last year, when she was one, she teetered up to houses and looked super cute scoring “things” to put in her bag. She didn’t understand what she was getting was candy or that candy was something you ate. This year it’s a whole different ball game.

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  • 4 Tips for Reducing Formula Supplementation in the Hospital

    Posted October 27, 2015 by Kristie Velarde

    When a patient recently delivered her second baby at Harris Health System’s Lyndon B. Johnson Hospital in Houston, she was surrounded by a team dedicated to supporting her decision to breastfeed. The support, which began in the delivery room and continued after she returned home, made a difference.

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  • New Video: Methods for Moving a Nation

    Posted October 22, 2015 by Cindy Hutter

    In this new video from the IM CoIIN project, hear how the project is cleverly combining three key methods for change—collaborative learning, innovation networks and quality improvement—to achieve results in reducing infant mortality across the country.

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  • Save a Life With Your Facebook Feed

    Posted October 20, 2015 by Cindy Hutter

    While Pregnancy and Infant Loss Remembrance Day is only a day, and SIDS Awareness Month is only a month, education and awareness have lasting effects. By working together through the power of social media, we can save more babies.

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  • NY Hospital Sees Breastfeeding Rates Soar with Neonatologist Leading Change

    Posted October 15, 2015 by Kristie Velarde

    Yogangi Malhotra, MD, attending neonatologist and an early champion of breastfeeding, knew it wouldn’t be easy to bring change to New York’s Montefiore New Rochelle Hospital. But, her unique role as a neonatologist and the QI project team leader helped foster change more quickly in five key areas.

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  • The Vision That Ties Us Together

    Posted October 13, 2015 by Scott Berns, MD, MPH

    I will do everything within my power to continue NICHQ’s legacy of making improvements that matter in the lives of all children and families—so that ALL children can achieve their optimal health.

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  • Baby-Friendly Hospitals Go From Crawling to Cruising

    Posted October 08, 2015 by NICHQ

    The new issue of Vital Signs from the Center for Disease Control and Prevention focuses on hospital actions that influence breastfeeding—and there is good news. Hospitals are making progress implementing the Ten Steps to Successful Breastfeeding, evidence-based practices that create an environment to support mothers who choose to breastfeed.

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  • Holding Your QI Gains without the Pain

    Posted October 06, 2015 by Cindy Hutter

    Ensuring sustainability is not something you do at the end of a project; it should be built in from the start. If you are panicking and thinking, “But we haven’t done that!” Don’t worry. Your project most likely has a sustainability focus without you even realizing it.

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  • Paying Tribute to My 'Letterman'

    Posted October 01, 2015 by Scott Berns

    As Scott Berns prepares to take the reigns as NICHQ's new President and CEO next week, he reflects on the past and looks ahead to the organization's bright future.

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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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  • A Breastfeeding Culture Starts in the Community, Not the Hospital

    Posted August 27, 2015 by Heidi Agostinho

    I have worked in Florida helping women to breastfeed for over 25 years and I have heard multiple stories of mothers being misdirected and unsupported by healthcare professionals. I also experienced it myself. So in 2009, when I was asked to begin a project to help Florida hospitals become Baby-Friendly designated and make policy and environmental changes that most believed to be impossible, I couldn’t say no.

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  • A Retrospective: The Development and Use of the Vanderbilt ADHD Behavior Rating Scales

    Posted August 24, 2015 by NICHQ

    The rate of attention deficit hyperactivity disorder (ADHD) diagnosis has jumped 15 percent in the last six years according to recent data from the Center for Disease Control and Prevention. The NICHQ Vanderbilt Assessment Scale, developed through the ADHD Learning Collaborative, remains a foremost tool for helping healthcare professionals diagnose the disease. We recently invited Mark Wolraich, MD, from the University of Oklahoma Health Sciences Center, the creator of the Vanderbilt Rating Scales (from which the NICHQ version was adapted), to share the story of the scales’ development, utility and their continued relevancy.

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  • Why I Participate: By Parent Partner Jennifer Ferrieri

    Posted August 18, 2015 by Jennifer Ferrieri

    Jennifer Ferrieri, a mother of two, shares her breastfeeding experience and why she joined the New York State Breastfeeding Quality Improvement in Hospitals (BQIH) Collaborative as a parent partner.

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  • Georgia Becomes Baby-Friendly One Hospital at a Time

    Posted August 13, 2015 by Cindy Hutter

    For DeKalb Medical Center in Decatur, Georgia, becoming designated as Baby-Friendly somehow always got relegated to a “someday list” when there was more time, more resources and fewer competing priorities. Now, someday is today. DeKalb Medical became the first hospital in Georgia to earn Baby-Friendly accreditation, a status which is reserved for birthing facilities that meet recommended care guidelines for lactating mothers and their babies. Georgia families are grateful.

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  • The Linchpin in Patient-Centered Medical Home Transformation

    Posted August 11, 2015 by NICHQ

    NICHQ has long been a champion for the active participation of family partners on improvement teams. The reason is simple: system improvement should be driven by the perspective of the people most closely affected by the system’s performance. This was a foundational principle for the CHIPRA Massachusetts Medical Home Initiative, in which the engagement of family partners on improvement teams helped transform 13 pediatric practices into patient-centered medical homes (PCMHs). As a result, the initiative was among the nominees for the 2015 John Q. Sherman Award for Excellence in Patient Engagement.

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  • The Gift of a Mother Partner

    Posted August 05, 2015 by Rebekka Henriksen

    In my role as Mother Chair for the New York State Breastfeeding Quality Improvement in Hospitals (BQIH) Collaborative, it has been my privilege to help participating hospital teams connect with and utilize their local parent partners. At times, however, hospital teams struggle with the why’s (why is this role important) and how’s (how can a parent, and more specifically, a mother partner contribute to the implementation of the 10 Steps to Successful Breastfeeding).

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  • 218,000 More Babies Per Year to Be Delivered at Baby-Friendly Hospitals

    Posted August 03, 2015 by Cindy Hutter

    NICHQ is proud to celebrate breastfeeding awareness through World Breastfeeding Week and National Breastfeeding Month. These observances come on the heels of a report detailing impressive results from Best Fed Beginnings, a NICHQ-led, groundbreaking national initiative to help hospitals improve breastfeeding-related maternity care and increase the number of Baby-Friendly hospitals in the U.S.

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  • Expanded Portfolio Inches NICHQ Closer to Vision

    Posted July 31, 2015 by NICHQ

    NICHQ is thrilled to be awarded three new projects. With each project, and with the support of our fantastic partners, we’re inching closer to NICHQ’s vision of a world where all children achieve their optimal health.

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  • Medicaid Reimbursement Policies for LARC Aid Awareness, Use

    Posted July 29, 2015 by Claire Rudolph and Ellen Pliska of ASTHO

    LARC methods include intrauterine devices (IUD) and hormone contraceptive implants that prevent ovulation. While women can begin to use LARC at any time, ACOG has identified the immediate post-partum (IPP) timeframe as being particularly favorable due to the convenience for both patients and providers, as well as increased motivation of women to seek contraceptives. Even with this guidance, rates of LARC insertion during IPP remain low.

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  • 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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  • QI Tips: A Formula for Developing a Great Aim Statement

    Posted July 22, 2015 by NICHQ

    Research shows teams who develop a good aim perform better. A good aim statement captures the voice of the customer, of those we serve. It provides alignment of multiple stakeholders, helps keep the team focused on the tasks at hand, creates the urgency to accomplish the goal, provides a vision of what success looks like, and serves as a predictor of success. Here’s some guidance on how to write a great aim statement.

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  • Parent Partner Advice: Get Involved in Any Way That You Can!

    Posted July 15, 2015 by Cindy Hutter

    Andrea Thompson is a parent partner on the quality improvement team for the Kingwood Medical Center in Kingwood, TX. The hospital is participating in the Texas Ten Step Star Achiever Breastfeeding Learning Collaborative, which seeks to help hospitals improve their maternity care practices to better support mothers who choose to breastfeed. Thompson has been extremely active with Kingwood’s breastfeeding support group, as well as its social media efforts to engage mothers. We recently sat down with the mother of a 3-year-old boy, Troy, to find out more about her role as a parent partner.

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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 Hospital 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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  • Why I Participate: By Parent Partner Malorie Thurman

    Posted July 02, 2015 by Malorie Thurman

    Malorie Thurman, a mother of three, says she joined the Texas Ten Step Star Achiever Breastfeeding Learning Collaborative as a parent partner as a way to see that mothers are given the best possibility to experience the outcome they desire with their delivery. "This was my opportunity to give back to those who had been so helpful to me and my family. It is a wonderful feeling knowing you have been an intricate part of such amazing changes that will impact so many people in and around your community."

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  • Good Things Come in Small Changes

    Posted June 30, 2015 by Elissa Faro, PhD

    We’ve all employed the process of trial and error at some point. Small tests of change, however, transform trial and error into a disciplined process of trial and learning. The more small tests we run, the easier it becomes to make an effective, sustainable change.

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  • New Guide for Improving Sickle Cell Disease Treatment in the ED Helps Close Disparity Gaps

    Posted June 25, 2015 by NICHQ

    Sickle cell disease patients wait in excruciating pain longer than they have to for treatment. Guidelines do exist, but they have not been consistently implemented, particularly in acute care settings. Our new guide was designed to help providers bridge this gap.

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  • Hospital Breaks Barriers for Cesarean Section Couplet

    Posted June 23, 2015 by Kristie Velarde

    Incorporating system-level changes at hospitals to stop the separation of mother and baby post C-section has been a particularly challenging area for hospitals. But with months of coaching from NICHQ about how to implement system changes under their belt, nurses at Good Samaritan Hospital Medical Center knew a recent scenario was an opportunity for change.

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  • Viewpoint: A Novel Method for Tackling Complex Population Health Problems

    Posted June 17, 2015 by NICHQ

    In a Viewpoint published in JAMA Pediatrics, NICHQ authors illustrate how collaborative improvement and innovation networks (CoIINs) can be implemented to achieve results in a population health context.

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  • Strengthening and Leveraging Preconception and Interconception Health

    Posted June 15, 2015 by NICHQ

    In a blog post co-authored by NICHQ's IM CoIIN Project Director Elaine Fitzgerald, read about how national partnerships are elevating the work of promoting women's health before (preconception) and in between (interconception) pregnancies.

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  • A Look Back at 4 Years of Improving Sickle Cell Disease Care at a Systems Level

    Posted June 11, 2015 by NICHQ

    From 2011 to 2015, NICHQ served as the National Coordinating and Evaluation Center for the Sickle Cell Disease Newborn Screening Program (SCDNBSP). NICHQ convened grantee teams and collaborated with them to focus on areas of similarity (acute care; care coordination/medical home; screening and follow up; self-management; and transition of care) to achieve breakthrough improvements in care for children and adults with SCD.

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  • Fire Chief Puts Baby Skin-to-Skin

    Posted June 09, 2015 by NICHQ

    One nurse at Champlain Valley Physicians Hospital has taken spreading evidence-based maternity care practices to a new level—well, more accurately, a new place: a home delivery.

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  • Investigating a Possible Link Between Substance Abuse and Infant Mortality

    Posted June 04, 2015 by Rachel Kremen

    Washington state is known for having a low rate of infant mortality—fifth lowest in the U.S. But the state is still actively working on reducing infant mortality even further. In fact, leaders in the state are developing an interesting strategy that targets substance abuse.

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  • A Positive Step Toward Exclusive Breastfeeding Rate Improvement

    Posted June 02, 2015 by NICHQ

    A recent study published by Pediatrics highlights that the percentage of hospitals distributing formula to breastfeeding mothers at time of discharge has decreased significantly in recent years, a positive sign toward hospitals embracing evidence-based maternity care practices that support a mother’s choice to breastfeed.

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  • Best Fed Beginnings Hospital Still Making Headlines: MUSC Opens First Milk Bank in South Carolina

    Posted May 29, 2015 by Cindy Hutter

    Best Fed Beginnings alumni hospital Medical University of South Carolina (MUSC) has launched a milk bank in South Carolina. The milk bank will provide breast milk to very low birth-weight babies (weighing less than 3.3 pounds) in neonatal intensive care units throughout the state.

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  • How One Mom is Raising the Profile of Sickle Cell Disease

    Posted May 27, 2015 by Cindy Hutter

    Tammy Smith’s daughter, Precious, often got sick as a baby and she cried—a lot. It wasn’t until Precious became so sick and nearly died that Tammy took her to a different hospital for treatment and learned that Precious had sickle cell disease (SCD). Fast forward 30 years and Tammy is making sure other families don’t have the same experience that she and her daughter had.

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  • Inspiring Video: How States Are Reducing Infant Mortality Rates

    Posted May 21, 2015 by Cindy Hutter

    In this new video from the IM CoIIN project, you can hear success stories and strategies being used to reduce infant mortality and eliminate racial disparities in cities, counties and towns across the US.

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  • Keeping the Donations Flowing Past the Halfway Mark

    Posted May 19, 2015 by NICHQ

    Your support allows us to continue our multi-sector, multidisciplinary work to reduce infant mortality and improve birth outcomes in the United States. While we hope you will take our $50 challenge and donate to our campaign, we would be remiss if we didn’t shine a light on some of the other great organizations within “The Next 10” campaign working on global infant health initiatives.

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  • Making Breastfeeding Support a Community Affair

    Posted May 14, 2015 by Kristen Holmstrand

    In Plattsburgh, a small town in upstate New York, creating a support group for breastfeeding mothers may have been driven by the local hospital, but it quickly became the community's baby.

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  • High-Profile Coverage for a High-Passion Concern

    Posted May 11, 2015 by Lauren A. Smith, MD, MPH

    We are excited and galvanized by our progress so far in reducing infant mortality and hope you will help us spread awareness about this critically important issue. I invite you to participate, learn, share and donate through the Huffington Post fundraising campaign. Our eyes are on the prize of reducing infant mortality and eliminated disparities in infant mortality.

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  • Putting Unsafe Sleep Marketing to Bed

    Posted May 08, 2015 by Tricia Finnerty

    It's vitally important that parents and other infant caregivers receive consistent and accurate messaging on safe sleep—from their healthcare providers, their support systems, state agencies and what they see in media and retail. But unfortunately, expectant families receive a lot of mixed messages.

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  • A First Response to Safe Sleep Habits

    Posted May 06, 2015 by NICHQ

    Thousands of infants die each year in unsafe sleep conditions. Sadly, the majority of sleep related deaths are preventable. One innovative and successful approach to reduce this tragedy is to train law enforcement, fire rescue squads and other first responders to educate families about safe sleep habits.

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  • Advice from One MD to Another on Supporting Breastfeeding

    Posted May 01, 2015 by Todd Wolynn, MD, IBCLC, MMM

    I’m often asked how I, a man, got involved in breastfeeding medicine. The truth is: I just happened to be in the right place at the right time. And that experience made me the right person.

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  • Why I Participate: By Parent Partner Lilia Rodriguez

    Posted April 28, 2015 by Lilia Rodriguez

    Prior to our daughter, Selah, being born in 2013, I had many visits to the doctor’s office with concerns about medical issues. I was told we would have to wait and see how the delivery went: “You may require a scheduled C-section.” The first thought that raced through my mind was: I want to be alert to breastfeed my baby.

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  • A New Day Aborning for Childbirth

    Posted April 21, 2015 by Jeannette T. Crenshaw, DNP, RN, LCCE, IBCLC, NEA-BC, FAAN

    Because safe and healthy birth sets the stage for successful breastfeeding, we also need focus in a similar way on the actions everyone can take to promote safe and healthy birth.

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  • Snowballs Used to Be Cool

    Posted February 26, 2015 by Jack Maypole, MD

    Boston’s historical snowfall has crippled transit systems, stressed overtaxed social support networks and created insurmountable challenges for all. But, most especially, it has created substantially more difficult—and at times potentially dangerous—conditions for parents of medically complex children who have marginal access to care in the best of times.

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  • How to Start a Community Healthy Weight Clinic

    Posted February 17, 2015 by Cindy Hutter

    The Holyoke Health Center’s Healthy Weight Clinic is changing lives. In a recent 5-month group session, nearly 50 percent of the participants decreased their BMI. We recently sat down with the center’s director, Vincent Biggs, MD, to get tips for starting and running a healthy weight clinic.

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  • Breastfeeding Collaboratives Provide Road Map for Long-Term Success

    Posted February 16, 2015 by Kristie Velarde

    Increasing exclusive breastfeeding rates can seem like a lofty goal for some hospitals, particularly when rates hover below 20 percent. Several hospitals participating in NICHQ-led learning collaboratives found a path that not only brought double-digit growth, but also set the stage for Baby-Friendly designation. Now these hospitals are using best practices to sustain breastfeeding rates and improve outcomes in other clinical areas.

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  • Sickle Cell Pain Protocol Reduces Wait Times for Meds and Eases Patient Frustration

    Posted February 13, 2015 by Rachel Kremen

    To improve the care of its sickle cell patients, Boston Medical Center developed a drug protocol that makes it possible to make quick, accurate decisions about acute care. As a result, the average time to first dose of medication for sickle cell patients experiencing a pain crisis dropped from nearly an hour to 22 minutes. ER staff also stopped second-guessing sickle cell patients asking for pain killers.

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  • Breastfeeding Success Depends On Support During Pregnancy As Much As After

    Posted February 09, 2015 by Pamela Berens, MD

    Most new moms have heard the message that breastfeeding is best for the health of their baby. Unfortunately, successfully meeting a breastfeeding goal isn’t always as easy as deciding to breastfeed. Having ongoing education about breastfeeding during pregnancy can help just as much as post pregnancy, yet it is often not emphasized enough.

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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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