<p> The American Academy of Pediatrics (2012); the American College of Obstetricians and Gynecologists (2016); and the Association of Women’s Health, Obstetric, and Neonatal Nurses (2015) endorses breastfeeding exclusively for six months, followed by continuation with complementary foods through age one year to achieve the most personal and public health benefits. However, while most mothers initiate breastfeeding, the majority do not meet their goals due to lack of support (CDC, 2016). </p><p> The Affordable Care Act mandates coverage for breastfeeding support, but federal, state, and insurance policies are not conducive to making such benefits accessible. </p><p> Electronic registration and medical record documentation allow for improved tracking and decreased risk to the facility. </p><p> This paper outlines the development and implementation of administrative practices in an existing Registered Nurse/Internationally Board-Certified Lactation Consultant (RN-IBCLC) led outpatient lactation clinic at a Baby Friendly (2012) designated facility with goals of increasing access to lactation support postpartum, improving patient outcomes, and realization of financial viability. Expected outcomes included identification of best practices and implementation strategies for the following: a. provider collaboration including outreach efforts to trigger referrals. b. number of dedicated hours per week to offer services. c. cost/benefit analysis. d. registration and documentation process. e. model of care. f. funding source. </p><p> Tests of change through plan-do-study-act (PDSA) cycles were based on the outcome of a gap analysis. Modifications to implementation were made dependent on PDSA cycle findings until optimized RN-IBCLC-led outpatient lactation clinic administrative practices for the facility and processes became streamlined. </p><p> Despite limited literature to guide administrative practices, the project met the aims of patient registration and electronic health record (EHR) documentation. However, extensive policy and systems barriers existed that prevented success in identifying a workable revenue stream despite the efforts of this investigator in collaboration with parent system-level managed care, finance, and compliance departments. </p><p> The solution agreed upon to provide sustainability to the program was to utilize outpatient lactation visits as a community benefit to quantify lost revenue of services provided and aid the hospital. Even though the lack of revenue equaled lack of department growth, the community benefit option added a layer of stability to the program as it stands. </p><p> This project provides a model for other organizations examining best practices in administrative and funding options for IBCLC-led outpatient lactation clinics. Thereby; creating sustainable breastfeeding support leading to improved health of mothers, babies, and the community.</p><p>
Identifer | oai:union.ndltd.org:PROQUEST/oai:pqdtoai.proquest.com:13860718 |
Date | 26 April 2019 |
Creators | Fassler, Lori |
Publisher | McKendree University |
Source Sets | ProQuest.com |
Language | English |
Detected Language | English |
Type | thesis |
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