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ObjectiveTo implement and evaluate the use of the conflict management framework (CMF) in four tertiary UK paediatric services.DesignMixed methods multisite evaluation including prospective pre and post intervention collection of conflict data alongside semistructured interviews.SettingEight inpatient or day care wards across four tertiary UK paediatric services.InterventionsThe two-stage CMF was used in daily huddles to prompt the recognition and management of conflict.ResultsConflicts were recorded for a total of 67 weeks before and 141 weeks after implementation of the CMF across the four sites. 1000 episodes of conflict involving 324 patients/families across the four sites were recorded. After implementation of the CMF, time spent managing episodes of conflict around the care of a patient was decreased by 24% (p<0.001) (from 73 min to 55 min) and the estimated cost of this staff time decreased by 20% (p<0.02) (from £26 to £21 sterling per episode of conflict). This reduction occurred despite conflict episodes after implementation of the CMF having similar severity to those before implementation. Semistructured interviews highlighted the importance of broad multidisciplinary leadership and training to embed a culture of proactive and collaborative conflict management.ConclusionsThe CMF offers an effective adjunct to conflict management training, reducing time spent managing conflict and the associated staff costs.

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Human milk is the optimum form of nutrition for infants. If babies with neonatal jaundice can maintain adequate intake at the breast in the absence of clear medical indications, exclusive breastfeeding should continue while the infant receives phototherapy. The United Nations Baby Friendly Hospital's Initiative (BFHI) is a 10-step plan to encourage health facilities in establishing successful breastfeeding practices.Objectives: This clinical audit aims to detect the rates of exclusive breastfeeding among babies admitted with neonatal jaundice and identify potential risk-factors for breastfeeding practices in the pediatric department of the BFHI accredited Latifa Women and Children Hospital in Dubai, United Arab Emirates. Methods Methods The presented audit is a retrospective study of the electronic medical records of babies admitted to the pediatric department of Latifa Women and Children Hospital with a primary diagnosis of neonatal jaundice from 1 st September 2020 till 30 th September 2021. A total of 59 babies were included in the audit after accounting for the exclusion criteria; < 35 weeks gestation, prolonged jaundice (> 3 weeks of age), bilirubin levels approaching exchange transfusion levels, hypoglycemia (blood glucose < 45 mg/ dL), and hypernatremic dehydration (urea > 50 mg/dL+/-Na > 150 mmol/L). Results 48(81%) babies received exclusive breastfeeding during their hospital stay. Among the babies receiving formula feeds (11, 19%), 55% received formula feeds prior to admission to the pediatric ward. Rates of consults to International Board-Certified Lactation Consultant remained low in both exclusive breastmilk-fed and formula milk-fed cohorts (20% vs 36%). Among the underlying risk factors for breastfeeding practices, higher maternal age and formula milk supplements within 24 hours of birth remained significantly different between the two cohorts (figure 1).