National Baby-Friendly Initiative Quality Improvement Collaborative

A national Baby-Friendly Initiative (BFI) Quality Improvement Collaborative Project with 25 maternity hospital teams across Canada was implemented by the Breastfeeding Committee for Canada from June 2019 to December 2021.This project was funded by the Public Health Agency of Canada to improve maternal child health outcomes by improving breastfeeding rates in Canada. The Institute for Healthcare Improvement Breakthrough Series and the Associates Press Model for Improvement were used to guide the BFI Project. Hospital teams were supported to complete annual self-assessments, create aim statements, develop action plans, and collect monthly and quarterly data, and test for improvements using PDSA quality improvement strategies. Additionally, teams were supported with monthly educational webinars, workshops and team meetings with the National BCC Baby-Friendly Project Director and Quality Improvement Consultant. Feedback from teams indicated that the collaborative was helpful in meeting their BFI implementation goals. The aggregate data has shown significant improvement in documentation of care practices, improved rates of skin-to-skin care at birth for both vaginal and caesarean births, improved assistance and support with breastfeeding within 6 hours of birth as well as improved rates of mother & baby rooming-in. Individual teams have also seen significant improvement in exclusive breastfeeding rates from birth to hospital discharge. One team achieved BFI designation during the project timeline and several other teams are poised to apply for BFI designation in the coming months. Despite the pandemic impacts for health systems, teams were overall successful in improving maternity care practices and breastfeeding outcomes.