%0 Journal Article %A Amol Joshi %A Atul Londhe %A Trupti Joshi %A Laxmikant Deshmukh %T Quality improvement in Kangaroo Mother Care: learning from a teaching hospital %D 2022 %R 10.1136/bmjoq-2021-001459 %J BMJ Open Quality %P e001459 %V 11 %N Suppl 1 %X Background Kangaroo Mother Care (KMC) is a low-resource, evidence-based, high-impact intervention for low-birth weight (LBW) care. Quality improvement in KMC requires meso-level, macro-level and micro-level interventions. Our institution, a public teaching hospital, hosts a level-II/III neonatal intensive care unit (NICU). The average demand for beds typically exceeds available capacity, with 60% occupancy attributed to LBW patients. There was low uptake of KMC practice at our unit.Aim statement In the initial phase, we aimed to improve the coverage of KMC in admitted eligible neonates from a baseline of 20%–80% within 15 days. After a period of complacency, we revised the aim statement with a target of improving the percentage of babies receiving 6-hour KMC from 30% to 80% in 12 weeks.Methods We report this quasi-experimental time-series study. With the Point of Care Quality Improvement methodology, we performed Plan-Do-Study-Act (PDSA) cycles to improve KMC practice. We involved all the healthcare workers, mothers and caregivers to customise various KMC tools (KMC book format, KMC bag, mother’s gown) and minimise interruptions. Feedback from all levels guided our PDSA cycles.Results The percentage of babies receiving at least 1-hour KMC increased from 20% to 100% within 15 days of August 2017. In the improvement phase, baseline 6-hour KMC coverage of 30% increased to 80% within 12 weeks (October–December 2017). It sustained for more than 2 years (January 2018 till February-2020) at 76.5%±2.49%.Conclusions Quality improvement methods helped increase the coverage and percentage of babies receiving 6-hour KMC per day in our NICU. The duration specified KMC coverage should be adopted as the quality indicator of KMC. The training of healthcare workers and KMC provider should include hands-on sessions involving the mother and the baby. Maintaining data and providing suitable KMC tools are necessary elements for improving KMC. Minimising interruption is possible with family support and appropriate scheduling of activities. Having a designated KMC block helps in peer motivation.Data are available upon reasonable request. Data is available with the corresponding author on request. We comply with BMJ’s policy of sufficient anonymisation to ensure that patients are not directly identified. The information is in the form of a master chart in MS Excel 2019 containing daily documented KMC hours received by each baby during her stay in the hospital over more than 26 months. It is available in four MS Excel sheets, having date-wise KMC hours in rows and individual babies as columns. Columns are colour-coded for a particular month. %U https://bmjopenquality.bmj.com/content/bmjqir/11/Suppl_1/e001459.full.pdf