Do small baby units improve extremely premature infant outcomes?
| Autor: | Kanekal Suresh Gautham, Joseph W. Kaempf |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Opportunity cost Quality management Scrutiny Unintended consequences business.industry MEDLINE Obstetrics and Gynecology Unit (housing) 03 medical and health sciences 0302 clinical medicine restrict 030225 pediatrics Intensive care Pediatrics Perinatology and Child Health medicine 030212 general & internal medicine Intensive care medicine business |
| Zdroj: | Journal of Perinatology. 42:281-285 |
| ISSN: | 1476-5543 0743-8346 |
| DOI: | 10.1038/s41372-021-01076-9 |
| Popis: | Increasing numbers of neonatal intensive care units have formed small baby units or small baby teams with the intention to optimize care of extremely premature infants. Considerable time, energy, and resources are required to develop and sustain complex quality improvement constructs, so legitimate questions about effectiveness, unintended consequences, and lost opportunity costs warrant scrutiny. The small baby unit literature is diminutive. Errors of chance, bias, and confounding secondary to insufficient definitions of process and outcome metrics, overlapping quality improvement projects, and limited cost analyses restrict firm conclusions. Well-established quality improvement methodologies such as evidence-based guidelines, standardized variability reduction using measurement-and-adjust techniques, family-integrated focus, and developmentally sensitive care, reliably improve outcomes for all-sized premature infants. There is not compelling published evidence that adding specialized small baby units or designated teams for extremely premature infants further enhances short- or long-term health if robust quality improvement fundamentals are already imbedded within local culture. |
| Databáze: | OpenAIRE |
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