Engaging in the Quality Improvement Process represents an opportunity for lactation consultants and breastfeeding advocates to examine and reevaluate hospital breastfeeding policies and procedures. Cause and effect diagrams that explore the problem of an 8-hourold baby who has not yet breastfed are presented as examples of a quality tool.
1. US Department of Health and Human Services. Healthy People 2000. Washington, DC: DHHS, 1991:149-150.
2.
2. Cunningham AS, Jelliffe DB, Jelliffe EFP. Breastfeeding and health in the 1980s: A global epidemiological review. J Pediatr1991; 118:659-666.
3.
3. Winikoff B, Myers D, Laukaran VH, Stone R.Overcoming obstacles to breast-feeding in a large municipal hospital: Applications of lessons learned. Pediatrics1987;80:423-433.
4.
4. Romero-Gwynn E, Carias L.Breast-feeding intentions and practice among Hispanic mothers in southern California. Pediatrics1989; 84:626-632.
5.
5. Walton M. The Deming Management Method. New York: Putnam Publishing Group, 1991.
6.
6. Joint Commission of Accreditation of Healthcare Organizations: 1996 Comprehensive Accreditation Manual for Hospitals. Oakbrook Terrace, IL: JCAHO, 1996.
7.
7. Lebbov W, Scott W.Service Quality Improvement: The Customer Satisfaction Strategy for Health Care. Chicago: American Hospital Publishing, 1992:9-9.
8.
8. Schaffer R, Thomson H.Successful change programs begin with results. Harvard Bus Rev1992; 70:80-89.
11. Winikoff B, Baer E.The obstetrician's opportunity: Translating "breast is best" from theory to practice. Am J Obstet Gynecol1980; 138:105-117.
12.
12. Samuels SE, Morgan S, Schoen EG. Incidence and duration of breastfeeding in a health maintenance organization population. Am J Clin Nutr1986; 42:504-510.
13.
13. Cronenwett L, Stukel T, Kearnet M, Barnett J, Covington C, Del Monte K.Single daily bottle use in the early weeks postpartum and breastfeeding outcomes. Pediatrics1992; 90:760-766.
14.
14. Ciampa D.Total Quality: A User's Guide for Implementation. Reading, MA: Addison-Wesley, 1991:6-6.
15.
15. Ishikawa K.Guide to Quality Control. White Plains, NY: Asian Productivity Organization and Quality Resources, 1982:18-46.
