Equity and Safe Sleep for Infants (ESSI)
Aim 1
By December 2025, greater than 70% of Illinois birthing and children’s hospitals will address disparities and promote neonatal equity by actively participating in the ESSI initiative.
Aim 2
By December 2025, greater than 80% of infants will be discharged from ILPQC hospitals with a completed ESSI bundle.
ESSI April 2024 Newsletter: Healthcare Professional Commitment Safe Sleep Education
Healthcare Professional Commitment: Key Resources
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- All physicians and providers, nurses, ancillary clinicians and hospital staff completing E-Modules
- At least 1 ESSI Team Member attends PQI training
- Host at least 1 facilitated discussion
- System to facilitate feedback from peers, parents and families
Use the following tools to create your own hospital’s plan for implementation!
Webinars
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Upcoming Webinars
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Past Webinars
June 2024: Inclusive Clinical Environment: Equitable and Inclusive Unit Policies
April 2024: Healthcare Professional Commitment: Safe Sleep Environment Education and Implementation, Part 2
March 2024: Healthcare Professional Commitment: Safe Sleep Environment Education and Implementation
February 2024: Healthcare Professional Commitment: Equitable and Respectful Care, Part 2
January 2024: Healthcare Professional Commitment: Equitable and Respectful Care
January 2024: ESSI Data Training Webinar (View Recording)
December 2023: QI Team Lead Support Call (View Recording)
November 2023: ESSI Launch Call (View Recording)
ESSI Toolkit
- Initiative Onboarding Resources & Data Forms
- National Guidelines and Position Statements
- Healthcare Professional Commitment: Equitable and Respectful Care Education and Implementation
- Healthcare Professional Commitment: Safe Sleep Environment Education and Implementation
- Inclusive Clinical Environment
- Parent and Caregiver Empowerment
- Community Partnerships
- Healthcare Data Utilization
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Initiative Onboarding Resources & Data Forms
- American Board of Pediatrics MOC Attestation Form – ESSI
- ESSI Initiative and Key Strategies Poster **
- 10 Steps to Getting Started with ESSI
- ESSI Key Driver Diagram
- ESSI IDPH Letter of Support
- ESSI Monthly Newborn Data Form **
- ESSI Monthly Hospital Measures Data Form **
- ESSI Data Training Webinar (View Recording)
- ESSI Frequently Asked Questions **
- ESSI Team Meeting: Example Agenda
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National Guidelines and Position Statements
- AAP Equity and Inclusion Efforts
- AAP Policy Statement: The Impact of Racism on Child and Adolescent Health (2019)
- AAP Policy Statement: Eliminating Race Based Medicine (2022)
- AAP Policy Statement: The Impact of Racism on Child and Adolescent Health (2019)
- AAP Policy Statement: Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment (2022)
- AWHONN Diversity, Equity, and Inclusion at AWHONN
- NANN Position Statement #3070: Racial Disparity in the NICU (2020)
- NANN Position Statement #3075: Trauma-Informed Care in the NICU (2022)
- NANN 9 Recommendations for Equality in Care
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Healthcare Professional Commitment: Equitable and Respectful Care Education and Implementation
I-PROMOTE-IL Implicit Bias Training Directory: ESSI Teams may find the following e-learning modules in the directory most helpful.
Use our ILPQC Implementation Template to create your education plan with the resources below. These resources are also listed in the document linked here.
e-Learning Modules
Live Trainings
- PQI SPEAK UP Champion Training – Live web-based training over two half days. (Contact PQI for cost)
- March of Dimes – Live web-based/in person training. (Contact MOD for cost)
Listening to Parent and Family Voices – Birthing peoples’ stories of care experiences
Tools to Facilitate Discussion
Research Publications on Hospital-Implemented Practices with Tools for Adaptation
- Health Equity Rounds: An Interdisciplinary Case Conference to Address Implicit Bias and Structural Racism for Faculty and Trainees – Tools included in appendices.
- Addressing implicit bias and health disparities in a level IV NICU: Lessons learned from a novel NICU approach demonstrating examples of implicit bias.
Films
- Toxic – A Black Woman’s Story – This drama looks at how race, toxic stress, and birth outcomes are intertwined. Available to purchase with accompanying discussion guide via instructions on the website.
- Laboring with Hope – This short documentary is about loss, grief, and the hope for improving health outcomes for Black women. Available to purchase with accompanying discussion guide via instructions on the website.
- Aftershock – This documentary film witnesses two families become ardent advocates in the maternal health space after the tragic loss of two women following the deliveries. Available on Hulu.
- PQI 28-day Anti-Racism Challenge, v2 – Daily activities to reflect and provide you tools to support your anti-racism efforts.
Creating Discussion Questions
Resources for Respectful Care Practices
- ILPQC Actionable Respectful Care Strategies
- NEW ILPQC ESSI RCP Poster – Adapted from Birth Equity, this poster can be used to promotes respectful care practices within the NICU.
- Spanish ESSI RCP Poster
- ILPQC Birth Equity RCP Poster – Promotes respectful care practices on unit
- RCP Sign Off Sheet – Promotes commitment to respectful care practices
- Patient Reported Experience Measure – Facilitates feedback from patients to identify opportunities to improve respectful care
- NEW ILPQC ESSI RCP Poster – Adapted from Birth Equity, this poster can be used to promotes respectful care practices within the NICU.
- AWHONN Respectful Maternity Care Implementation Toolkit – Toolkit for health care professionals in maternity settings to integrate respectful maternity care into their area of work or influence
- The SHARE Approach – A five-step process for shared decision making from the Agency for Healthcare Research and Quality (AHRQ)
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Healthcare Professional Commitment: Safe Sleep Environment Education and Implementation
ILPQC ESSI Education Training Resources
e-Learning modules
- Cribs for Kids: Hospital-Wide Infant Safe Sleep Training – Hospital wide safe sleep training module (Free)
- Cribs for Kids Safe Sleep Ambassador Education Outreach Program ** – Additional training available to any organization or individual to emphasize the importance of safe sleep education.
- Cribs for Kids Safe Sleep Ambassador Education Outreach Program ** – Additional training available to any organization or individual to emphasize the importance of safe sleep education.
- NIH Safe to Sleep Provider Training and Materials – Training for healthcare, public health, and service providers about safe infant sleep with tips on how to communicate safe sleep messages to diverse audiences (Free, 1.5 CEs)
Endorse and model a safe sleep environment
- ILPQC Safe Sleep Crib Cards – This file has two options, “Ready for ABCs of Safe Sleep” and “Not Quite Ready for my ABCs of Safe Sleep”. With additional guidelines on the backside, these crib cards serve as an example of educational material that can be utilized by any hospital.
- Anatomical Diagram Teaching Tool: Created by New York State Perinatal Quality Collaborative. Available in English, Spanish, Haitian Creole, Bengali, Korean, Russian, Chinese, Arabic, French, Urdu, Yiddish, Italian, and Albanian.
- Modeling Safe Practices: A Checklist for Infant Sleep & Breastfeeding Images
- Safe Sleep Photography Guidelines: Guideline of what published images can be displayed that are in accordance with the Recommendations of the American Academy of Pediatrics Safe Sleep Infant Sleeping Environment
- Approved Safe Sleep Images Gallery: Imagery that promotes infant sleep that can be displayed across all hospital mediums. Hospitals may also find their state or hospital association, or other regional safe sleep organization to find images.
- Cribs for Kids Audit (Jan 2023) – Audit tool checklist (Y/N) to determine if safe sleep is observed or unsafe sleep is observed in the clinical environment.
- NICU Safe Sleep Positioning (SSP) Algorithm – Project algorithm utilized by Hwang et.al to determine which NICU infants are eligible for safe sleep positioning.
- 2024 Breastfeeding and Safe Sleep: Evidence-Based Practices Guidance Document – This document provides a template for health care providers to incorporate ongoing support of breastfeeding while following safe sleep guidelines, beginning in the prenatal period through the first 24 months of life.
- NIH Clear the Crib Directions for Implementation: The #ClearTheCrib Challenge is a fun activity that raises awareness about safe infant sleep. This provider handout from the NIH goes through the general steps to implement Clear the Crib and provides additional resources.
Encourage meaningful, culturally appropriate, respectful, nonjudgmental conversations.
- AAP Safe Sleep Communication Strategies: AAP suggest providers consider these strategies when crafting messages
- NICHQ Building on Campaigns with Conversations: Web-based guide with approach including discussion guides for supporting caregivers to help overcome barriers to safe sleep and breastfeeding.
- Child Safety Forward: A Reflection Guide to Shape Provider Conversations about Infant Sleep : This guide is set up to offer providers a tool based on Child Safety Forward learning to help think through how bias shows up at the individual, relational, and institutional level and helps re-design our work with community so that we stand a far greater chance of finding solutions in partnership with them around the universal goal of child safety.
- Cribs for Kids: Hospital-Wide Infant Safe Sleep Training – Hospital wide safe sleep training module (Free)
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Inclusive Clinical Environment
Secondary Driver 1: Organizational Leadership Commitment
Secondary Driver 2: Equitable and Inclusive Unit Policies
- CDC Gateway to Health Communication – CDC Health Communication Gateway is a one-stop shop for health communicators. This resource specifically highlights Inclusive Communication Principles to consider when creating and disseminating health information.
- Minnesota State Applying an Equity Lens to Policy Review – This document is a protocol for policy review that provides a structure for institutionalizing the considering of equity in the process of making, implementing, and assessing policy.
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Policy and Process Review Tool Through an Equity Lens – This is an equity lens tool adapted from the Minnesota Department of Public Health. This tool provides supplemental questions to consider when looking at existing policies, developing new policies, and examining current processes.
Secondary Driver 3: Parent and Caregiver Experience Prioritization
- Use qualified interpreters and provide information in multiple languages
- ILGA HEALTH FACILITIES AND REGULATION (210 ILCS 87/) Language Assistance Services Act. 210 ILCS 87/ Language Assistance Services Act. (ilga.gov)
- Encourage your unit to highlight data, stories, and strategies pertaining to racial equity
- Racial/Ethnic Disparity in NICU Quality of Care Delivery: Significant racial and/or ethnic variation in quality of care exists between and within NICUs. Providing feedback of disparity scores to NICUs could serve as an important starting point for promoting improvement and reducing disparities.
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Parent and Caregiver Empowerment
Secondary Driver 1: Respectful Parent and Caregiver Partnerships
- National Institute for Children’s Health Quality (2023) – 4 Tips for Including & Engaging Family Partners in Your Work
- ILPQC 5 Steps to Engaging a Parent Partner
- ILPQC Actionable Respectful Care Strategies
- ILPQC BE RCP Poster – Birth Equity tool that focuses on respectful care and collaboration with caregivers
- RCP Sign Off Sheet
- Patient Reported Experience Measure – Obtain feedback from patients to determine next steps for action to improve respectful care
- ILPQC Respectful Care Breakfast Guide
Secondary Driver 2: Safe Sleep Awareness
- National and State Resources
- AAP Safe Sleep Campaign Toolkit – American Academy of Pediatrics has developed a suite of materials including posters, infographics, videos and social media messages.
- Illinois Safe Sleep Support – A program for families in Illinois through the Illinois Department of Human Services to learn about the safest ways for their babies to sleep, get answers to their sleep safety questions, and get access to items they need to keep their babies safe.
- NIH Safe to Sleep – Education materials include ways to reduce risk, safe sleep environment, breastfeeding and safe sleep, and tummy time.
- Handouts and Posters
- Illinois Safe Sleep Support Handout – 4 ways to keep your baby safe while they sleep. Available in 5 Languages (English, Spanish, Chinese, Arabic, Polish)
- NICHQ Myth VS Fact – Safe Sleep – Myths versus facts on safe sleep from NICHQ
- NICHQ Safe Infant Sleep Baby Registry Guide – Recommendations for keeping infants safe and healthy.
- NYSPQC Safe Sleep Baby Brochure – Tips on following the ABCs.
- Anatomical Diagram Teaching Tool: Created by New York State Perinatal Quality Collaborative. Available in English, Spanish, Haitian Creole, Bengali, Korean, Russian, Chinese, Arabic, French, Urdu, Yiddish, Italian, and Albanian.
- First Candle Safe Sleep Guidelines – What You Need to Know
- Cribs for Kids – 9 Steps for Safe Sleep: Poster that lists the appropriate ways to engage in safe sleep practices (Available in Spanish)
- Videos
- E-module
- The Cribs for Kids Safe Sleep Ambassador Training: Training available to any organization or individual to emphasize the importance of safe sleep education.
- Safe Sleep and Breastfeeding
- Safe Infant Sleep and Breastfeeding Support: What to Consider When Looking for Child Care: Checklist/guide to support caregivers assess two important aspects of child care, safe infant sleep and breastfeeding, as they decide who will care for their baby.
- NICHQ Myth VS Fact – Breastfeeding : Myths versus facts on breastfeeding and safe sleep from NICHQ
- Safe Sleep Information for Other Caregivers
- A Safe Sleep Guide for Childcare Providers: Created by the Department of Human Services, Hawaii, this guide defines SIDS and SUID, reviews the ABCs, and provides a guide to ensuring infants in your care have a safe sleep environment.
- NICHD Caregiver Education: The Safe to Sleep campaign offers a variety of free materials, including booklets, handouts and infographics, to help people learn about safe infant sleep and share safe sleep information with friends, family, and others.
- NICHQ Safe Sleep in Child Care Settings : A handout and FAQ for non-parental caregivers in child-care settings.
- Other Tools and Resources
- NICHQ Safe Infant Sleep Baby Registry Guide: Recommendations for keeping infants safe and healthy
- FAQs around Safe Sleep and a Stuffy Nose
- NICHQ Safe Infant Sleep Baby Registry Guide: Recommendations for keeping infants safe and healthy
Secondary Driver 3: Transition to Home, including SDoH Screening and Resource Linkage
- Transition to Home
- AAP healthy newborn discharge criteria
- NICU Transition to Home: This research article describes the results of a quality improvement initiative done in the NICU to improve discharge readiness.
- SDoH Screening Tools
- Safe Sleep Screening Tools and Documentation
- Cribs for Kids Safe Sleep Screening Tool: Questionnaire determining SDoH for parent/infant
- JCMH Safe Sleep Assessment Tool: Assessment determining SDoH for parent/infant
- NAPPSS-IIN Interview Tool: Safe Sleep Education Assessment Tool determining SDoH for parent/infant
- Cardinal Glennon Safe Sleep Assessment Tool
- Bright Futures Tool and Resource Kit: 3-5 day visit “Your Family’s Health and Wellbeing” screening questions (page 2)
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Community Partnerships
Secondary Driver 1: Resource Mapping
- FindHelp resource
- NowPow
- ILPQC Tools
- Social Determinants Mapping Tool- ILPQC Mapping worksheet to organize social determinants of health key contacts, resources and services in your local area available to support patients.
- Social Determinants of Health Resource Tools- ILPQC Summary of Tools to identify resources and services to address Social Determinants of Health
- ILPQC Tip Sheets – List of tools and programs to address Social Determinants of Health needs
- AAP IL Tools
- Housing Work – Improving child health and housing
- Childhood Nutrition Safety
Secondary Driver 2: Building Relationships with Community Organizations
- Bridging out to your community
- Making Community Partnerships Work – A Toolkit: Creating and sustaining a partnership requires patience, an understanding and appreciation of group process, and cultural sensitivity. This toolkit is designed to give you the background and tools you may need to engage a community in a partnership. You will learn how to work with community members to achieve a shared goal.
- NYSPQC Promoting Safe Sleep in the Community: Document; overview of the steps that NYSPQC has taken as a community-based organization to lead safe sleep efforts in the region.
- Engaging Community Partners Tip Sheet: Check out this sheet for insight on how to identify a community partner, tips for building partnerships, and more.
- Community-based approaches to infant SS and BF (2023)- Qualitative study
- Support safe sleep
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- Cribs for Kids Third-Party Funding Document: Example of a Funding letter to a third-party provider to help with safe sleep.
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Healthcare Data Utilization
Staff training to optimize race, ethnicity and language (REAL) data collection
- AHA – Optimizing REAL Data Collection: Optimizing race, ethnicity and language (REAL) data collection in reducing health care disparities: Collection and use of race, ethnicity and language data (American Hospital Association)
- AHA – Develop a Methodology for Data Collection: Developing a methodology for data collection in reducing health care disparities: Collection and use of race, ethnicity and language data (American Hospital Association)
- Equity Care Report August (2013): A guide that supports hospitals and care systems working to reduce health care disparities and promote equitable care; intended to increase the percentage of hospitals committed to improving equity of health care in the coming years.
Scripts to optimize REAL data collection
- AHA- Staff training and script examples- one page extract of staff training and scripts from the American Hospital Association for improving the collection and accuracy of the patient-reported race/ethnicity data.
- AHA – How to ask the questions- one page extract of how to ask the questions regarding race/ethnicity examples from the American Hospital Association for improving the collection and accuracy of the patient-reported race/ethnicity data.
ILPQC process flow diagram for race & ethnicity data collection
- Process Flow for Race Ethnicity Data Collection with Staff Responses_Neo
- Process Flow for Race Ethnicity Data Collection with Staff Responses
Standardized process to review, analyze, and share data stratified by race, ethnicity, and insurance status
- HRET: framework for stratifying race, ethnicity, and language data
- HRET Equity Care Toolkit Eliminating Healthcare Disparities
- ILPQC_ Hospital Guide to stratifying data by patient demographics
Standardized process to address identified bias, inequities, and disparities from race, ethnicity, and insurance data.
- illinois-2022-mpinc-report-508- mPINC survey report; the survey measures care practices and policies that impact newborn feeding, feeding education, staff skills, and discharge support.
**Key Resource
The following material is an example only and not meant to be prescriptive. The resources provided in this toolkit are for informational purposes only. The exclusion of a resource, program, or website does not reflect the quality of that resource, program or website. Note: websites and URLs are subject to change.