Archives of Disease in Childhood | 2019
P162\u2005Using implementation science methodology to achieve quality improvement outcomes for the national healthy childhood programme in ireland
Abstract
On average over 62,000 babies are born in Ireland every year. Life expectancy for men and women in Ireland has increased significantly since the foundation of the state. There is good evidence that investment in early childhood is cost-effective, delivering both an economic and a social return. One of the ways to assure these returns is to deliver a universal, evidence-based child health programme, thereby achieving the best outcomes for children. Ireland’s ‘National Healthy Childhood Programme’ is free to all children up to the age of 14 years. In common with international models, it consists of three components: child health assessments, screening and immunisations. In 2014 the Health Service Executive’s Child Public Health Group reviewed the international evidence and updated the existing child health programme (Best Health for Children 2005). This also triggered the development of formal structures to support child health screening, a restructuring of some of the key child health contacts and the implementation of an ambitious programme of work called the ‘Nurture Programme – Infant Health and Wellbeing’. The focus of Nurture was to improve the knowledge and professional skills of front-line providers of the service and also the information and support available to parents during pregnancy and for the first three years of their child’s life. We developed the programme using the principles of implementation science, which included a systematic and standardised child-centred approach. We developed a blended learning programme aimed at the healthcare professionals who provide care to children and their parents on a daily basis. We also developed a child health website and supporting resources for parents. This was achieved by early engagement of stakeholders and by collaboration with parents and front-line health care providers. Formal evaluation of the needs and experiences of parents and frontline staff helped shape the methodology of implementation of evidence based interventions and also allowed for the recognition of potential barriers to quality improvement, and enhanced adaptability to challenges as they arose. This presentation will outline how this integrated approach led to the development of quality improvement interventions where sustainability was considered from the outset.