Interview with Lucy Davidoff - Co-Author of Action Brief 4.1: Delayed Cord Clamping
Tuesday, January 28, 2020
By Siena Davis, MPH, Project Manager, PQI
“You don’t have to have a DNP or a PhD… You don’t have to be the attending physician... All perinatal health professionals with these tools can successfully implement a practice change.” -Lucy Davidoff
Lucy Davidoff, BA/BSN, RN, works in the Neonatal Intensive Care Unit the at the University of Maryland Medical Center. She is pursuing a Doctorate of Nursing Practice in the Neonatal Specialty at the University of Maryland School of Nursing. Lucy co-authored QI Action Brief 4.1: Delayed Cord Clamping, which was released in June of 2019.
Can you tell me a few reasons why delayed cord clamping is important?
“Delayed cord clamping is important for a lot of reasons. It’s a really simple practice change… Oftentimes, when we think about practice changes, they are expensive and complicated. It’s nice when you get a practice change that, in some ways, is walking back our medical practices and connecting with much older obstetric/midwifery practices. To be able to have a very huge impact on such a vulnerable patient population, just by waiting a few seconds to act, is pretty powerful. Coming from the nursing world, I really appreciate how interdisciplinary the practice change is. It requires small, but significant changes on the part of every person on the team.”
Can you describe the process you went through in selecting this topic?
“I started just thinking about my patient population and what are some practice changes that have good evidence behind them that a small, dedicated team can be successful in accomplishing. Delayed cord clamping fit all of those objectives.”
How would you explain a QI Action Brief to someone who hasn’t used one before?
“It’s a learning tool, or guide, on how to think through effectively making actionable clinical changes... It helps a team create a driver diagram, or a logic model, and think through potential barriers and how to mitigate those barriers, potential facilitators and how you might enable those facilitators to help with your practice change.”
What do you see as the value of using a QI Action Brief?
“Utilizing the Action Brief helps guide you through the research and process that informs the best way to implement delayed cord clamping. Especially if you haven’t been academically trained in this area, these are a great short cut to helping you succeed.”
Can you briefly describe the main sections of the Action Brief?
Section 1: Case Study
“The case study takes you step-by-step through a scenario… I think the case study gives a really good, real-life, example of why and how you would use these tools.”
Section 2: Education on the Topic
“The education [section] is basically a quick walkthrough of the given case study topic, pathophysiology, protocols, guidelines, and some tips on why it’s important and how to implement it.”
Section 3: Education on QI Concepts, Methods, & Tools
“This last set of slides really pulls it all together and gives education on… the importance of quality improvement and implementation science. How best to use the tools? How best to get an interdisciplinary team together? How to motivate a group?”
“It’s really helpful to have [the templates], especially if you can print them out ahead of listening to the Action Brief. Give them a look over as your listening through. Think about how you would fill them out. Obviously, if you’re implementing practice change at your own setting, having those blank diagrams to work through on your own, or with a small workgroup, is helpful.”
What do you hope subscribers will learn from the QI Action Brief you co-authored?
“We all talk about how we struggle to translate evidence into practice. There’s that missing link. I think these tools, these Action Briefs, can really help to bridge that divide… I think it helps you lay out a clear process for improvement.”
What did you learn from the process of co-authoring this QI Action Brief?
“I learned a lot. For me, being in the middle of my doctorate, we are touching on a lot of these topics in my academic setting. I see the other side of it in my clinical practice. I think actually doing the Action Brief was, in many ways, one of the first time I started from the beginning and connected the academic world to my clinical practice… I feel a lot more confident about developing and implementing quality improvement practice changes in the future.”
Which QI tool do you find the most useful?
“Definitely the force field analysis. One of the things I find most helpful is that assessment of what could possibly come up. It’s so great if you can, before that problem arises, figure out a way around it so you don’t have it in the first place. Sort of an acknowledgement of ‘We might have this problem and when we do, we have a plan for how to approach it.’”
Is there anything else you would like to add?
“When Dr. Bingham first asked me if I would be interested in writing an Action Brief, I definitely felt hesitant and nervous. ‘I don’t know if I’m qualified to do that.’ I think it’s such a good reminder that anyone can do these! It’s one step at a time... one foot in front of the other. Walk through the tools and I think you come out really successful on the other side.”
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