The EASE Project Revisited: Improving Safe Sleep Practices in Ohio Birthing and Children’s Hospitals

Abstract

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.

Expansion of a multi-pronged safe sleep quality improvement initiative to three children’s hospital campuses

“…(Mason et al 2013;Leong et al 2019) Multiple studies have utilized crib audits to collect information such as patient age, sleep position/location and environment, followed by a quality improvement (QI) program in children's hospitals and birthing centers; they found that safe sleep practices could be greatly improved. (Mason et al 2013;Leong et al 2019;Macklin et al 2019;Shadman et al 2016;Macklin et al 2016;Moon 2011) In response to Georgia's high infant mortality rate, the Georgia Safe to Sleep campaign was initiated in 2016 to model and educate both parents and caregivers on safe sleep practices in mother-baby units at birthing hospitals. (Georgia Department of Public Health 2016) In 2017, we performed a study at a freestanding tertiary care children's hospital to study the effectiveness of a quality initiative aimed at safe sleep compliance before and after QI interventions.…”