Evidence-Based Quality Improvement in Neonatal and Perinatal Medicine: The Neonatal Intensive Care Quality Improvement Collaborative Experience: FIGURE 1

PEDIATRICS ◽  
2006 ◽  
Vol 118 (Supplement 2) ◽  
pp. S57-S64 ◽  
Author(s):  
Jeffrey D. Horbar ◽  
Paul E. Plsek ◽  
Janice A. Schriefer ◽  
Kathy Leahy
Keyword(s):  
Intensive Care ◽  
Quality Improvement ◽  
Neonatal Intensive Care ◽  
Care Quality ◽  
Evidence Based ◽  
Quality Improvement Collaborative ◽  
Perinatal Medicine

Using Economic Information in a Quality Improvement Collaborative

PEDIATRICS ◽  
2003 ◽  
Vol 111 (Supplement_E1) ◽  
pp. e411-e418
Author(s):  
Jeannette Rogowski
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Quality Improvement ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Care Quality ◽  
Treatment Costs ◽  
Quality Improvement Collaborative ◽  
Intensive Care Unit Treatment ◽  
Economic Information

This article provides an overview of neonatal intensive care unit treatment costs for hospitals that participated in the Neonatal Intensive Care Quality Improvement Collaborative Year 2000 (NIC/Q 2000) quality improvement collaborative and discusses how economic information can be used in quality improvement efforts. Detailed information on neonatal intensive care unit treatment costs is presented for 29 hospitals that participated in the NIC/Q 2000 collaborative. The sample consists of 6797 very low birth weight infants (1500 g or less at birth) with admission dates between January 1, 1997, and December 31, 1998. Information on median treatment cost per infant, ancillary costs, accommodation costs, length of stay, and cost per day is presented. In addition, ancillary costs are further disaggregated into those for respiratory therapy, laboratory, radiology, pharmacy, and all other ancillary services. The role of level of care and other factors that influence treatment costs are then explored.

Development of Potentially Better Practices for the Neonatal Intensive Care Unit as a Culture of Collaboration: Communication, Accountability, Respect, and Empowerment

PEDIATRICS ◽  
2003 ◽  
Vol 111 (Supplement_E1) ◽  
pp. e471-e481
Author(s):  
Judy Ohlinger ◽  
Mark S. Brown ◽  
Sue Laudert ◽  
Sue Swanson ◽  
Ona Fofah ◽  
...  
Keyword(s):  
Intensive Care ◽  
Quality Improvement ◽  
Neonatal Intensive Care ◽  
Care Quality ◽  
Care Group ◽  
Team Members ◽  
Leadership Management ◽  
Standards Of Conduct ◽  
Year 2000 ◽  
Multidisciplinary Teamwork

Objective. The Vermont Oxford Network (VON) CARE Group was formed in response to the need to create organizational cultures supportive of change and quality improvement. Methods. The CARE Group consisted of team members from 4 participating neonatal intensive care units (NICUs). All CARE Group members chose to work on multidisciplinary teamwork for the duration of the Neonatal Intensive Care Quality Improvement Collaborative Year 2000. A questionnaire was developed by the CARE Group and administered to the 4 focus group NICUs. The survey focused on 6 domains of the organization: unit coordination, working in the NICU, leadership, management of disagreements, authority, and unit culture. Benchmarking visits were completed to supplement the information found in the survey and the literature. Results. Seven potentially better practices (PBPs) were developed on the basis of the surveys, benchmark visits, and literature reviews. The PBPs include 1) a clear, shared NICU purpose, goals, and values; 2) effective communication among and between teams and team members; 3) leaders lead by example; 4) nurture a collaborative NICU environment with trust and respect; 5) live principled standards of conduct and standards of excellence; 6) nurture competent and committed teams and team members; and 7) commit to effective and positive conflict management. Conclusions. The CARE Group successfully used quality improvement methods and collaboration to delineate principles and practices of multidisciplinary teamwork.

Evaluation and Development of Potentially Better Practices to Prevent Neonatal Nosocomial Bacteremia

PEDIATRICS ◽  
2003 ◽  
Vol 111 (Supplement_E1) ◽  
pp. e504-e518
Author(s):  
Howard W. Kilbride ◽  
Richard Powers ◽  
David D. Wirtschafter ◽  
Michael B. Sheehan ◽  
Dianne S. Charsha ◽  
...  
Keyword(s):  
Intensive Care ◽  
Quality Improvement ◽  
Nosocomial Infection ◽  
Neonatal Intensive Care ◽  
Venous Catheter ◽  
Practical Experience ◽  
Evidence Based ◽  
Infection Rates ◽  
Long Term Effects ◽  
Nosocomial Sepsis

Objective. Six neonatal intensive care units (NICUs) that are members of the Vermont Oxford National Evidence-Based Quality Improvement Collaborative for Neonatology collaborated to reduce infection rates. There were 7 centers in the original focus group, but 1 center left the collaborative after 1 year. The objective of this study was to develop strategies to decrease nosocomial infection rates in NICUs. Methods. The process included a comprehensive literature review, internal practice analyses, benchmark studies, and development of practical experience through rapid-cycle changes, subsequent analysis, and feedback. This process led to 3 summary statements on potentially better practices in handwashing, approach to nosocomial sepsis evaluations, and central venous catheter management. Results. These statements provide a basis for an evidence-based approach to lowering neonatal intensive care unit nosocomial infection rates. Conclusions. The 2-year process also led to changes in the culture and habits of the institutions involved, which should in turn have long-term effects on other aspects of quality improvement.

Implementation of Evidence-Based Potentially Better Practices to Decrease Nosocomial Infections

PEDIATRICS ◽  
2003 ◽  
Vol 111 (Supplement_E1) ◽  
pp. e519-e533
Author(s):  
Howard W. Kilbride ◽  
David D. Wirtschafter ◽  
Richard J. Powers ◽  
Michael B. Sheehan
Keyword(s):  
Quality Improvement ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
Coagulase Negative Staphylococcus ◽  
Evidence Based ◽  
Review Of The Literature ◽  
Infection Rates ◽  
Quality Improvement Collaborative ◽  
Significant Area ◽  
Clinical Changes

Objective. Six neonatal intensive care units (NICUs) that are members of the Vermont Oxford National Evidence-Based Quality Improvement Collaborative for Neonatology collaborated to reduce infection rates. There were 7 centers in the original focus group, but 1 center left the collaborative after 1 year. Nosocomial infection is a significant area for improvement in most NICUs. Methods. Six NICUs participating in the Vermont Oxford Network made clinical changes to address 3 areas of consensus: handwashing, line management, and accuracy of diagnosis. The summary statements were widely communicated. Review of the literature, internal assessments, and benchmarking visits all contributed to ideas for change. Results. The principle outcome was the incidence of coagulase-negative staphylococcus bacteremia. There was an observed reduction from 24.6% in 1997 to 16.4% in 2000. Conclusions. The collaborative process for clinical quality improvement can result in effective practice changes.

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