Implementation Methods for Delivery Room Management: A Quality Improvement Comparison Study
| Autor: | Henry C. Lee, Margaret Crockett, Louis P. Halamek, Paul J. Sharek, Neil N. Finer, Paul S. Kurtin, Connie von Kohler, Mihoko V. Bennett, Kathy Chance, Richard J. Powers, David Blackney, Courtney C. Nisbet |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Quality management Article Cohort Studies Pregnancy medicine Humans Longitudinal Studies Prospective Studies Mailing list Prospective cohort study business.industry Delivery Rooms Delivery room Infant Newborn Risk adjustment Delivery Obstetric medicine.disease Quality Improvement Pediatrics Perinatology and Child Health Emergency medicine Comparison study Female Medical emergency business Neonatal resuscitation Cohort study |
| Zdroj: | PEDIATRICS. 134:e1378-e1386 |
| ISSN: | 1098-4275 0031-4005 |
| DOI: | 10.1542/peds.2014-0863 |
| Popis: | BACKGROUND: There is little evidence to compare the effectiveness of large collaborative quality improvement versus individual local projects. METHODS: This was a prospective pre-post intervention study of neonatal resuscitation practice, comparing 3 groups of nonrandomized hospitals in the California Perinatal Quality Care Collaborative: (1) collaborative, hospitals working together through face-to-face meetings, webcasts, electronic mailing list, and data sharing; (2) individual, hospitals working independently; and (3) nonparticipant hospitals. The collaborative and individual arms participated in improvement activities, focusing on reducing hypothermia and invasive ventilatory support. RESULTS: There were 20 collaborative, 31 individual, and 44 nonparticipant hospitals caring for 12 528 eligible infants. Each group had reduced hypothermia from baseline to postintervention. The collaborative group had the most significant decrease in hypothermia, from 39% to 21%, compared with individual hospital efforts of 38% to 33%, and nonparticipants of 42% to 34%. After risk adjustment, the collaborative group had twice the magnitude of decrease in rates of newborns with hypothermia compared with the other groups. Collaborative improvement also led to greater decreases in delivery room intubation (53% to 40%) and surfactant administration (37% to 20%). CONCLUSIONS: Collaborative efforts resulted in larger improvements in delivery room outcomes and processes than individual efforts or nonparticipation. These findings have implications for planning quality improvement projects for implementation of evidence-based practices. |
| Databáze: | OpenAIRE |
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