Marie's Outlook

Gap Analysis Essential for Achieving Baby-Friendly Designation

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Pursuing recognition as a Baby Friendly Hospital can be a long and complicated process. If your hospital is in the planning stage for “going Baby Friendly,” a gap analysis is usually the best place start. The purpose is to look at the difference between the existing state and the desired state. There are four main steps.

1: Develop SMART Goals.

SMART goals, often used in business, can function as a compass for an individual or organizational destination. “Business” may seem very far removed from “breastfeeding,” but here’s how you can apply this technique in lactation care.

  • Set goals that are specific. Be precise in writing exactly what it is you want to have happen. To jump-start your thinking, try to answer the questions of who-what-where-when-how.
  • Set goals that are measurable. “Improving breastfeeding at the hospital” isn’t measurable. Having 75% of newborns breastfeeding on discharge is.
  • Set goals that are attainable. Make sure you have the resources to achieve your goals. These should include not only financial and personnel resources, but also the attitudes, abilities, and skills needed to reach those goals. Ideally, your SMART goals should align with your hospital’s goals, because hospital goals may substantially affect your available resources.
  • Set goals that are realistic. For example, it’s unlikely that you will ever be successful in convincing all mothers to breastfeed.
  • Set goals that are time-oriented. Set a target date for achieving your goal.

2: Document Your Current State.

One of the things I’ve found, over and over, is that people involved in the designation process assume that something is or isn’t happening in their facility, even if the evidence to back up those assumptions is sparse or non-existent. It’s critical to take a good, hard, honest look.

3: Analyze Why the Gap Exists.

There are a number of models that can help you to figure out why your organization’s current state is falling short of where you would like it to be, but my favorite is Lewin’s change theory. Lewin says that every situation has restraining forces (obstacles) and driving forces (facilitators). This elegantly simple model is easier to remember than it is to use. While it doesn’t take too much effort to identify big, glaring obstacles or facilitators, the devil is in the details. Often, people inside the hospital are too close to the situation to clearly identify the more subtle factors that are holding them back, or those that could propel them forward.  A good place to start? Look at the people, policy (or policies), equipment and other resources, the environment, and “other” miscellaneous factors. As you might imagine, “other” factors are often illusive, but critical for change.

4: Write a Report.

I feel strongly about the importance of writing down what you believe yourself to know. Otherwise, you often find yourself with a bunch of information floating around in your head in an unclear, non-cohesive fashion. Writing the report of your gap analysis helps you solidify your thoughts.

People often dislike taking the time to do any of these steps—this last one most of all. However—like so many other things that are good for us and disagreeable—it’s necessary. To leap to the next step without completing this one would be foolhardy, introducing the risk that you will forget information or make mistakes in the analysis and planning phase. If that happens, I can almost guarantee you will have a slow or painful implementation phase. Take whatever time you and your team need to compile and write a clear analysis report.

Sometimes, clients ask me, “Should we do this for all Ten Steps?” The answer is yes. The Ten Steps all work together. The total is greater than the sum of the parts.

Sometimes, people ask “What could a consultant do for us?” Well, a consultant checks your compass frequently, sees your driving and restraining forces more clearly, and makes suggestions for the journey.

When clients or potential clients talk to me about “going Baby-Friendly” I like to remind them that they are in fact, “going.” It’s a journey. The gap analysis is their compass; a consultant is their wind and sails.

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