“It was challenging, in a good way,” says Vanessa Dacey, BFUSA’s Accreditation Director.
She’s speaking about the need to revamp many of BFUSA’s policies and systems when it became clear that assessors would not be able to visit facilities in person during the pandemic. BFUSA paused all assessments in March 2020 and quickly engaged in strategic planning to respond to this period of great uncertainty.
“It was just not practical to consider doing onsite assessments, especially given the impacts of COVID-19 that hospitals were experiencing at that point,” says Dacey.
The strategy was to split the assessment into two parts. Part One included the aspects of the assessment that involved document review utilizing a secure uploading system set up via One Drive. Part One also included the interviews with healthcare professionals. In the beginning, the hope was that the pandemic would lift in time to conduct Part Two of the assessment in person for those facilities that successfully completed Part One virtually.
“We started doing Part One virtual assessments in October 2020,” Dacey recalls. “But when winter was approaching, it became evident that conducting Part Two assessments in person would not be feasible.”
So, by early 2021, the team was pivoting again, seeking a new process for conducting Part Two of the assessment via virtual platforms as well.
“Everyone rallied together in a great way,” says Dacey. “It was nice to come up with something innovative and to work with such a wonderful team.”
The group’s motto was provided by BFUSA’s former CEO, Trish MacEnroe.
“Trish would often say, ‘Keep your knees bent.’ You know, like when you’re skiing, anticipating the bumps,” says Dacey. “I would say that a lot to people because we had to make a lot of tweaks along the way.”
In May 2021, BFUSA began conducting both parts of the assessment via virtual platforms. The first two facilities designated this way were Crisp Regional Hospital in Cordele, Georgia, and Presbyterian Hospital in Lower Manhattan.
Crisp Regional Hospital
Crisp Regional had been working toward Baby-Friendly designation for several years. They had completed the Georgia Five Star program and were quickly moving through the 4D Pathway with BFUSA.
April Thompson (third from the right) with her colleagues at Crisp Regional Hospital
“We had everything lined up and we had full support from everyone involved,” recalls April Thompson, RN-BSN, BBA, Director of the Women’s Center at Crisp.
“And then COVID happened and that threw us off just a tad,” she says with a sarcastic laugh.
Their original plan was to be assessed sometime in the summer of 2020. Thompson was hoping they would be designated in time for the birth of her third child, Emilee, who was born at the hospital on October 1.
“I joked that I wanted to be Baby-Friendly before I have this baby. Even though we weren’t officially Baby-Friendly, everything was as if we were – because we were ready,” she says.
When they finally got the chance to be assessed virtually, Thompson and her team jumped at the opportunity.
“It was different, obviously, but they made it so seamless that I didn’t have any problems with it. I’ve actually talked with two other smaller hospitals since we did this and recommended it to them. I feel like it went really well virtually,” she says.
Presbyterian Hospital – Lower Manhattan
The second facility to be designated through the virtual process was Presbyterian Hospital in Lower Manhattan, a world away from rural Georgia. Like Crisp, they started their Baby-Friendly journey through a program with their state.
Barbara Alba (first row, second from left) with her colleagues at Presbyterian Hospital – Lower Manhattan
“The New York Department of Health was looking for a cohort of hospitals to help through the process to increase the number of Baby-Friendly hospitals in the five boroughs, and we were one of the three facilities they picked,” recalls Barbra Alba, PhD, RN, NEA-BC, Director of Nursing for Maternal Child Health at the Lower Manhattan campus.
They were in the last phase of the process when COVID hit.
“At that point, we made a conscious decision to move forward with Baby-Friendly and not allow COVID to deter us,” says Alba. “We had established the practices and we really didn’t want to lose our momentum.”
When BFUSA offered the opportunity to move forward virtually, Alba and her team were ready despite the challenges COVID was presenting.
“Everybody was so prepared – and so excited for it,” she says. “It was just great to see the energy.”
The virtual assessment went well, according to Alba. “I would say it was pretty seamless,” she says. “Our IT team was literally right behind us every step of the way. And BFUSA was incredibly patient and understanding. This was new to everybody.”
Reflecting on the progress they’ve made in the last few years, Alba points to the upward trends in their patient satisfaction scores (see chart).
“We really do attribute some of that to our Baby-Friendly journey,” says Alba. “The practices are hardwired and are sustainable. Everybody is speaking the same language and it’s coming out loud and clear from what our patients are saying. We’re thrilled.”
Looking back, Alba sees achieving Baby-Friendly designation as the pinnacle of her career.
“This is something we took on in OB and to see the success of it and to get to the other side of it has been nothing less than wonderful for all of us,” she reflects. “This is a legacy I hope to leave behind. Any time you know you’ve improved practice and patient satisfaction, these are the moments you wait for in your career.”