Dr Macklin provided key components of the project design, helped run learning collaborative and action period calls, fi nalized the data collection sheet, and drafted the initial manuscript; Drs Gittelman and Denny conceptualized and designed the project, helped run learning collaborative and action period calls, fi nalized the data collection sheet, and reviewed and revised the manuscript; Ms Southworth coordinated data collection at all sites and reviewed and revised the manuscript; Ms Wervey Arnold conceptualized and helped to design the program, helped to secure funding for the project, and reviewed and revised the manuscript; and all authors approved the fi nal manuscript as submitted.

Supplemental Digital Content is available in the text.

Literature has shown hospitalized infants are not often observed in recommended safe sleep environments. Our objective was to implement a quality improvement program to improve compliance with appropriate safe sleep practices in both children’s and birthing hospitals. Hospitalists from both settings were recruited to join an Ohio American Academy of Pediatrics collaborative to increase admitted infant safe sleep behaviors. Participants used a standardized tool to audit infants’ sleep environments. Each site implemented 3 PDSA (Plan-Do-Study-Act) cycles to improve safe sleep behaviors. A total of 37.0% of infants in children’s hospitals were observed to follow the current American Academy of Pediatrics recommendations at baseline; compliance improved to 59.6% at the project’s end ( P < .01). Compliance at birthing centers was 59.3% and increased to 72.5% ( P < .01) at the collaborative’s conclusion. This study demonstrates that a quality improvement program in different hospital settings can improve safe sleep practices. Infants in birthing centers were more commonly observed in appropriate sleep environments than infants in children’s hospitals.

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