Ghandour Reem M, Flaherty Katherine, Hirai Ashley, Lee Vanessa, Walker Deborah Klein, Lu Michael C
U.S. Department of Health and Human Services, Maternal and Child Health Bureau, Health Resources and Services Administration, Rockville, MD, USA.
Division of Epidemiology, Office of Epidemiology and Research, Maternal and Child Health Bureau, Health Resources and Services Administration, 5600 Fishers Lane, Room 18N122, Rockville, MD, 20857, USA.
Matern Child Health J. 2017 Jun;21(6):1318-1326. doi: 10.1007/s10995-016-2235-2.
Infant mortality remains a significant public health problem in the U.S. The Collaborative Improvement & Innovation Network (CoIIN) model is an innovative approach, using the science of quality improvement and collaborative learning, which was applied across 13 Southern states in Public Health Regions IV and VI to reduce infant mortality and improve birth outcomes. We provide an in-depth discussion of the history, development, implementation, and adaptation of the model based on the experience of the original CoIIN organizers and participants. In addition to the political genesis and functional components of the initiative, 8 key lessons related to staffing, planning, and implementing future CoIINs are described in detail.
This paper reports the findings from a process evaluation of the model. Data on the states' progress toward reducing infant mortality and improving birth outcomes were collected through a survey in the final months of a 24-month implementation period, as well as through ongoing team communications.
The peer-to-peer exchange and platform for collaborative learning, as well as the sharing of data across the states, were major strengths and form the foundation for future CoIIN efforts. A lasting legacy of the initiative is the unique application and sharing of provisional "real time" data to inform "real time" decision-making.
The CoIIN model of collaborative learning, QI, and innovation offers a promising approach to strengthening partnerships within and across states, bolstering data systems to inform and track progress more rapidly, and ultimately accelerating improvement toward healthier communities, States, and the Nation as a whole.
在美国,婴儿死亡率仍然是一个重大的公共卫生问题。协作改进与创新网络(CoIIN)模式是一种创新方法,运用质量改进科学和协作学习,已在公共卫生第四和第六区域的13个南方州应用,以降低婴儿死亡率并改善出生结局。我们基于CoIIN最初的组织者和参与者的经验,对该模式的历史、发展、实施和调整进行了深入讨论。除了该倡议的政治起源和功能组成部分外,还详细描述了与人员配备、规划和实施未来CoIIN相关的8个关键经验教训。
本文报告了该模式过程评估的结果。通过在24个月实施期的最后几个月进行的一项调查以及持续的团队沟通,收集了各州在降低婴儿死亡率和改善出生结局方面的进展数据。
对等交流和协作学习平台,以及各州之间的数据共享,是主要优势,并构成了未来CoIIN工作的基础。该倡议的一个持久遗产是临时“实时”数据的独特应用和共享,以指导“实时”决策。
协作学习、质量改进和创新的CoIIN模式为加强州内和州际伙伴关系、加强数据系统以更快地提供信息和跟踪进展,以及最终加速朝着更健康的社区、州乃至整个国家的改进提供了一种很有前景的方法。