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Implementing a Statewide Safe to Sleep Hospital Initiative: Lessons Learned

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Sleep-related infant deaths continue to be a major, largely preventable cause of infant mortality, especially in Georgia. The Georgia Department of Public Health (DPH), as part of a multi-pronged safe infant sleep campaign, implemented a hospital initiative to (1) provide accurate safe infant sleep information to hospital personnel; (2) support hospitals in implementing and modeling safe sleep practices; and (3) provide guidance on addressing caregiver safe sleep concerns. A process evaluation was conducted to determine progress toward four goals set out by DPH: (1) all birthing hospitals have a safe infant sleep policy; (2) all safe infant sleep policies reference the AAP 2011 recommendations; (3) all safe infant sleep policies specify the type and/or content of patient safe sleep education; and (4) all hospitals require regular staff training on safe sleep recommendations. Data were collected via structured interviews and document review of crib audit data and safe sleep policies. All 79 birthing hospitals in the state participated in the statewide campaign. Prior to the initiative, 44.3% of hospitals had a safe sleep policy in place; currently, 87.3% have a policy in place. The majority (91.4%) of hospitals have provided safe sleep training to their staff at this time. Important lessons include: (1) Engagement is vital to success; (2) A comprehensive implementation guide is critical; (3) Piloting the program provides opportunities for refinement; (4) Ongoing support addresses barriers; and (5) Senior leadership facilitates success.

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Funding for the educational support tools was provided by the Georgia Children’s Cabinet, led by First Lady Sandra Deal. The initiative is supported by the Georgia Chapter of the American Academy of Pediatrics; the Georgia Bureau of Investigation; the Georgia Hospital Association; and the Georgia Obstetrical and Gynecological Society. A special thanks goes to the Georgia Commissioner of Public Health, Brenda Fitzgerald, M.D. We thank the many hospital staff members for taking on this voluntary program and for sharing their experiences.

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Correspondence to Terri J. Miller.

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Miller, T.J., Salm Ward, T.C., McClellan, M.M. et al. Implementing a Statewide Safe to Sleep Hospital Initiative: Lessons Learned. J Community Health 43, 768–774 (2018).

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