Purpose: to provide support to health professionals at management level to structure a change process that will implement continuously improving use of SSC.

Management meeting

The target audience must include key decision makers and members of management with the authority to make and implement practice changes. Implementing SSC requires a systems management approach. Key stake holders that should attend include clinicians, nurses, department and unit managers, administrators, and finance managers. Such stake holders are however very seldom able to attend a whole day workshop, and therefore may come to the table ill-equipped with the information and reasons that motivate change. Attending a GR should however be a minimum expectation, the language and content will not lose them. Depending on the circumstances, context and individuals present, I can make a formal presentation as to the need, costs and benefits. Such a session should be followed by time for discussion and questions, a one hour time slot is adequate, specially if members attended GR or other presentations. A record of the meeting should be kept, and formally tabled to the management hierarchy for approval and followup. Management is fully entitled to make such approval conditional on more information, before releasing required resources. The resources required are in fact minimal, and the benefits greatly outweigh the cost.

Change team meeting

A desired outcome of such a meeting should be the formal appointment of and expressed support to a “change team”. That team should have a formal channel of communication to management, and at best could include a member of management. Such a team may already exist, in which case its members can be named in the minutes. One or two members of the team, not more, could be present at the above meeting.

Allowing for the prior presence of such a team, my involvement should entail a separate meeting with them. I would give a 30 – 40 minute presentation of some basic public health tools and concepts related to making health system changes. These are generic, and apply to making any change. However, change processes must always be unique, being determined by specific contexts, various cultures, current practices, and a host of other variables. My role would be that of a “catalyst”, identifying particular areas that have key leverage or that need attending to before other changes can follow. I would facilitate the identification of key objectives and means of achieving them, and I strive to make such facilitation without producing future dependency on my services! This requires a minimum of three hours, but can be shortened, or extended to a whole day.

Protocol review meeting

A specific part of the above process that can be done as a stand alone, is a round table meeting reviewing existing policies on skin-to-skin contact, breastfeeding and sensory support. This should be attended by senior clinicians, nursing unit managers, and clinical nurse practitioners. The existing protocol can be presented briefly, and then the evidence, interpretation and application of it discussed with a view to making improvements. I maintain a database in my laptop, and can leave references (and often pdf articles) for immediate review and study.