Using CDC's Maternity Practices in Infant Nutrition and Care (mPINC) Survey Results as a Catalyst for Change: Massachusetts Case Study

Results from the United States federally-sponsored Maternity Practices in Infant Nutrition and Care (mPINC) Survey were leveraged to bring together facility leaders who influence hospital breastfeeding practices to improve adherence to the standard of care. The April 2009 and April 2010 Massachusetts Mother-Baby Summits were one day long, foundation-sponsored, and invitation only. Participants had administrative responsibility for maternity care policies and operations. The first Summit included an inspirational keynote, in-depth CDC presentation on mPINC, workshops on QI methods and best practices for key interventions (e.g., ban-the-bags), and a Town Hall that encouraged participation from each institution. The second Summit included an inspirational keynote, institutional presentations of progress on a topic in each of the mPINC subscale domains, a workshop on measurement considerations for The Joint Commission's Perinatal Care Core Measure on exclusive breastmilk feeding, and a Town Hall. Eighty Massachusetts' decision makers representing 34 of the state's 50 facilities (covering 74% of births in the state) participated in the first Summit; 90 decision-makers representing 70% of the facilities and 85% of the births participated in the second Summit. Active engagement in problem solving generated a sense of enthusiasm and accomplishment. The collaborative spirit across traditionally competing hospitals demonstrated that these leaders were committed to quality and to improving their facilities' practices. An important aspect of the Summits was to foster transformational leadership by supporting participants in their envisioning, energizing, and enabling roles within their organizations. Cooperation from a broad array of stakeholders was found to be important for driving change.