Promoting Breastfeeding-Friendly Hospital Practices: A Washington State Learning Collaborative Case Study

Abstract

Background. Hospital breastfeeding support practices can impact breastfeeding outcomes. Learning Collaboratives are an increasingly common strategy to implement practices in healthcare, and have been applied to breastfeeding in many cases. Objectives. The aims of this study of the Evidence-Based Hospital Breastfeeding Support (EBBS) Learning Collaborative, a Washington State Department of Health (WA DOH) initiative, were to describe the perceptions of participants regarding the process and effectiveness of the EBBS Learning Collaborative, describe perceived barriers and facilitators to implementing the Ten Steps to Successful Breastfeeding, and to identify the needs for additional WA DOH actions and resources. Methods. Qualitative, semi-structured telephone interviews were conducted with 13 key staff that represented 16 of the 18 participating hospitals. Results. The Learning Collaborative was perceived positively by participants, meeting the expectations of nine, and exceeding the expectations of four persons interviewed. The most beneficial aspect of the program was its collaborative nature, and the most difficult aspect was the time required to participate, as well as technological difficulties. The key barriers were staff time, staff changes, cost, and the difficulty of changing the culture of hospitals and communities. The key facilitating factors were supportive management, participation in multiple breastfeeding quality improvement projects, collecting data on breastfeeding outcomes, tangible resources regarding the 10 Steps, and positive community response. EBBS participants stated that they would like to see WA DOH create a resource-rich, centralized source of information for participants Conclusion. This learning collaborative approach was valued by participants. Future efforts can be guided by these evaluation findings.