Lessons from the Early Implementation of the Best Fed Beginnings Learning Collaborative

Background: The Best Fed Beginnings project of the National Initiative for Children's Healthcare Quality (NICHQ), sponsored by the Centers for Disease Control and Prevention, has convened 90 hospital teams from across the US in an 18-month learning collaborative, which began in June 2012. The learning collaborative aims to improve hospital practices to support breastfeeding by helping hospitals achieve Baby-Friendly designation.

Methods: The collaborative employs the Breakthrough Series methodology, a quality improvement approach for rapidly spreading successful changes. This 18-month collaborative includes three “learning session” meetings interspersed with “action periods” (i.e., rapid-cycle testing and reporting data from interventions in individual hospitals). Teams meet in-person three times over the course of the 18-month period and receive support from national faculty with expertise in exclusive breastfeeding promotion, quality improvement methodology, and Baby-Friendly USA designation. Hospital teams utilize an online learning community web portal that allows them to upload and share monthly results, network with peers and mentor each other. Results are shared throughout the Collaborative across teams to promote learning. Evaluation research included baseline and six-month surveys and key stakeholder interviews.

Results: In this session, we present emerging lessons from the first four months of implementation, including two learning sessions and the beginning of one action period during which teams implement and measure small tests of change towards their aim of achieving Baby-Friendly USA designation. Data includes teams' aims, standardized measures used to track improvement, quality improvement data, and survey/interview data on emerging lessons across implementation.