Utilizing Lactation Acuity to Improve Lactation Services in a U.S. Hospital

Area of Science:

• Clinical Nursing
• Healthcare Management
• Lactation Support

Background:

• Current national staffing guidelines for hospital lactation services do not consider patient lactation acuity.
• Higher patient acuity necessitates advanced knowledge and skills from lactation care providers, often requiring International Board Certified Lactation Consultant (IBCLC) expertise.
• Inefficient resource distribution can compromise optimal care for breastfeeding patients.

Purpose of the Study:

• To evaluate the impact of implementing a lactation acuity classification system on staff resource distribution and patient care.
• To assess the effectiveness of the acuity system in optimizing the allocation of International Board Certified Lactation Consultant (IBCLC) time and improving overall lactation service productivity.

Main Methods:

• A lactation acuity classification system was implemented at a tertiary care teaching hospital.
• Lactation service reports, including over 10,000 consults from a 1-year period, were reviewed.
• Data analyzed included staffing, consult numbers, reasons for consults, acuity levels, and time spent by lactation providers.

Main Results:

• Implementation led to increased mean direct consult time and a higher acuity level for International Board Certified Lactation Consultant (IBCLC) cases.
• Eighty-five percent of IBCLC time was allocated to high-acuity consults, with trained nurses managing low-acuity patients.
• The percentage of patients receiving needed lactation consults increased, as did the number of consults per patient, enhancing team productivity.

Conclusions:

• A lactation acuity classification system effectively improves the distribution of staff resources in hospital lactation services.
• The system enhances the productivity of lactation teams and ensures that International Board Certified Lactation Consultants (IBCLCs) focus on complex cases.
• Data support the use of lactation acuity in developing recommendations for hospital lactation service staffing.