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Upcoming important dates, next steps for the Human Milk NCCC Phase II Initiative...

(The HM NCCC initiative's weekly email newsletter comes out every Wednesday.)

 
December 5, 2012
Reminder - Proposed checklist

tools
I have added the proposed checklist from the November 13th webinar to the extranet.  We will use the checklist as our next PDSA cycle through the end of December.  Please use the checklist and revise as needed to best suit your needs.  This would become a daily checklist that nursing will use to ensure all items have been performed. 


If your unit has developed criteria for skin to skin ie what infants can do skin to skin, what infants are ineligible for skin to skin please send me a copy!

 

In the literature...

news Kangaroo Mother Care in Kangaroo ward for improving the growth andbreastfeeding outcomes when reaching term gestational age in very lowbirth weight infants

.  

 

Sunil Ghavane, Srinivas Murki (srinivas_murki2001@yahoo.com), Sreeram Subramanian, Pramod Gaddam, Hemasree Kandraju, Sridevi Thumalla, Acta Pædiatrica 2012 101, pp. e545-e549

 

Aim: To study the effect of Kangaroo mother care in the Kangaroo ward in comparison

with conventional care at neonatal unit on growth and breastfeeding in very low birth

weight infants at 40 weeks' corrected gestational age.

 

Conclusion: Kangaroo mother care in the Kangaroo ward is as effective as conventional

care in the neonatal unit without any increase in morbidity or mortality in stable VLBW

infants


 

Culture:  Receiving the Boon

patients voice

The boon is the realization of the goal of the journey.  There is a recognition that all the previous steps served to prepare the organization for this benefit.  As new habits and identities begin to take root, the new culture moves from legitimacy to authenticity.  The change is palpable.  A culture of authenticity is first being true to one's own self and being what you say you are to others.  When a critical mass holds a shared identity, language and accountability, the result is nothing less than a social epidemic-it has reached a tipping point.  Epidemics are strongly influenced by the circumstances and conditions of the environment in which they operate, and human behavior is no exception.  Not only do behaviors become contagious, but the collective accountability factor kicks onto autopilot:  a self-correcting mechanism to adapt to a changing world 

 

(Kimball, 2005)

 

QI Tips: 

Creative Thinking   

   


PDSA

To develop changes that result in improvement, we often need to change our normal thought patterns. To do this, several methods can be useful: challenge the boundaries, rearrange the order of the steps, look for ways to smooth the flow of work, evaluate the purpose and challenge why you are doing something, visualize the ideal, and remove the current way of doing things as an option.

 

Challenge the Boundaries: People can be limited in their thinking by the boundaries they impose in a particular situation. To challenge these boundaries, begin by listing the boundaries within which a change must occur. Many times, the boundaries define the current system or how people view it. Real changes to the system are often outside the original constraints. Once the boundaries are listed, think  about how they can be expanded, or even eliminated.

 

Rearrange the Order of the Steps: List the activities involved in a process in order, and then move them around. Seeing the steps in another  order can provoke ideas for change that the regular order prevents. This idea is really a subset of the first idea, because the order in which things are done is a boundary. It is worth mentioning separately because it is so simple to do and often produces new ideas.

 

Look for Ways to Smooth the Flow of Work: Fluctuation in flow of work causes a ripple effect in all other aspects of the system. When flow is smoothed, things can get done more predictably.

 

Evaluate the Purpose, and Challenge Why You Are Doing Something: Take a close look at the reason activities are being performed. This approach often produces ideas for change such as eliminating steps that are not vital to the purpose. When people have been involved in an activity for a long time, it is found that steps often have been added to the process or system that were needed at one time but are no longer necessary. 

 

Visualize the Ideal: Describing aspects of the situation in an ideal state can generate new ideas for change. The phrase "Wouldn't it be nice if . . ." is an example of a visualization that can start the formation of ideas.

 

Remove the Current Way of Doing Things as an Option: New ideas for change are needed if the current system is not an alternative. Begin by understanding the current system. Then declare that a part or all of the current way of doing things can no longer be used. Let people explore the possible alternatives. 

 

It is helpful, when using the approaches suggested here or others to develop a change, that people are optimistic in first exploring the possibilities. There will be time to express critical thinking as the ideas for change are further developed.

 

 Langley, Gerald J.; Moen, Ronald D.; Nolan, Kevin M.; Nolan, Thomas W.; Norman, Clifford L.; Provost, Lloyd P. (2009-06-03). The Improvement Guide: A Practical Approach to Enhancing Organizational Performance (JOSSEY-BASS BUSINESS & MANAGEMENT SERIES) (Kindle Locations 1029-1031). Wiley Publishing. Kindle Edition.

 

 

December Webinar
 
conference call 

The next webinar will be Tuesday, December 11th, 2:00 - 3:00 PM.  Please plan to have at least one person from your team on the call so we can hear your 'voice'.  

   

 Each team be prepared to provide a 2-3 minute update on what your team is currently working on. We will review the latest data and the revised data collection tool. Please come prepared with ideas for the next PDSA cycles around Skin to Skin and also Pump Use.   

Over the next 5 months we will focus our attention as a collaborative on specific process measures for improvements. So you and your team can begin to think about these areas the schedule will be as follows:

 

  • Nov/Dec: Skin-to-Skin 
  • Jan: Pump Use 
  • Feb: Breastfeeding support 
  • Mar: Establishing milk supply 

 

If any team would be willing to present on any of these topics on the monthly webinars please contact me or I will be contacting you.

Click here for webinar information.

 

 

Contact


Tammy Haithcox  

 

Tammy Haithcox

 

PQCNC Clinical Initiative Manager

 

Tammy.Haithcox@pqcnc.org

 

 

 

 

 

 

 



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