Maternity facility readiness for new Joint Commission perinatal care core measure on exclusive breastfeeding: Massachusetts case study

Changing hospital practices could have a significant impact on infant feeding since the time around birth has been shown to be critical to breastfeeding success. The adoption of exclusive breastfeeding at discharge as part of the Joint Commission (JC) Perinatal Care Core Measure Set beginning April 2010 offers an important opportunity to improve the documentation and measurement of infant feeding. Our goal is to create a statewide consortium to improve accuracy, consistency, efficiency, and quality of breastfeeding rate measurement.

Massachusetts' mandate to make hospital medical records electronic prompted us to focus on how electronic medical records (EMRs) are meeting these documentation needs. We created a two-part survey to evaluate EMR usage in labor/delivery and postpartum and newborn care (Part 1) and to better understand current documentation of infant feeding practices for individual patients and the methods being used to determine aggregated rates of breastfeeding intent, initiation, and exclusivity (Part 2).

Part 1 of the survey was sent electronically to all 50 MA hospitals and birth facilities. Eighty-eight percent of facilities responded and 80% reported that they are already using some form of EMRs in labor/delivery, 64% in postpartum care, and 67% for newborns. Three vendors and in-house developed EMRs account for nearly all use. Respondents (98%) expressed interest in learning more about statewide collaborative efforts to collect rates. Part 2 data collection will occur in April 2010 in conjunction with the second annual MA MotherBaby Summit where maternity care facility leaders share best practices in improving quality of care.