1. A BBC document developed by Orange County RPPC with Title V funding through CDPH/MCAH, 2010 or How do we keep it going? Date:

2. Introductions  Name  Position  Facility

3. Assessments  Yours  Mine  Ours

4. From the Depths to the Peaks From the Depths to the Peaks San Francisco General Did It! San Francisco General Did It!

5. San Francisco General Hospital 2007 Maternal Race/ Ethnicity & Birthplace

6. San Francisco General Hospital 2004- 2007 Perinatal Characteristics  97.8% Medi-Cal Delivery  28.1% Incomplete High School  55.5% First Trimester Prenatal Care  1.4% No prenatal Care  11.4% Primary C-section  10.2% Repeat C-section

7. San Francisco General Hospital 2004- 2007 Any/Exclusive Breastfeeding

8. 2007 California’s Best Any/Exclusive Breastfeeding

9. California’s Lowest Scoring Hospitals 2007

10. Research – Can We Use It for Sustainability?  Ritualized behavior activity – activated by threat or perceived threat

11. Ethnic Beliefs & Birthing  Trends and themes –Special diets – spoiled milk –Decreased BF after immigration

12. Research-based Solutions  Cambodian diet initiation Galvin, et.al.Mat Child Health J, 2008  South Asian grandmothers’ groups  Ingram, et. al., Midwifery, 2003.

13. So, where are we?

14. Baseline Data

15. Next Steps

16.  Evaluate baseline data  Make conclusions  Take the conclusions to QI Committee  Revise Policies and procedures

17. Next Steps

19. Sustainability Looks Like...  Administrator training  Regular Multidisciplinary QI Committee meetings  Staff training  Train the trainer education  BBC network QI meetings  BBC evaluation access

20. Congratulations! You did it!

21. When we march together......we’re much more effective