Comparison of Collaborative Versus Single-Site Quality Improvement to Reduce NICU Length of Stay
| Autor: | Henry C. Lee, Steven G. Gwiazdowski, Michael W. Kuzniewicz, Heather Keller, Joseph Schulman, Paul J. Sharek, Courtney C. Nisbet, Ann Marie Mazzeo, Ruth Crowe, Paul S. Kurtin, Mihoko V. Bennett, Margaret Crockett |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Quality management MEDLINE Quality care 03 medical and health sciences 0302 clinical medicine Single site Intensive Care Units Neonatal 030225 pediatrics medicine Humans 030212 general & internal medicine Intersectoral Collaboration Early discharge Project group business.industry Infant Newborn Postmenstrual Age Infant Length of Stay Quality Improvement Patient Discharge Pediatrics Perinatology and Child Health Emergency medicine Female business Infant Premature |
| Zdroj: | Pediatrics. 142 |
| ISSN: | 1098-4275 0031-4005 |
| Popis: | BACKGROUND: There is unexplained variation in length of stay (LOS) across NICUs, suggesting that there may be practices that can optimize LOS. METHODS: Three groups of NICUs in the California Perinatal Quality Care Collaborative were followed: (1) collaborative centers participating in an 18-month collaborative quality improvement project to optimize LOS for preterm infants; (2) individual centers aiming to optimize LOS; and (3) nonparticipants. Our aim in the collaborative project was to decrease postmenstrual age (PMA) at discharge for infants born between 27 + 0 and RESULTS: From 2013 to 2015, 8917 infants were cared for in 20 collaborative NICUs, 19 individual project NICUs, and 71 nonparticipants. In the collaborative group, the PMA at discharge decreased from 37.8 to 37.5 weeks (P = .02), and early discharge increased from 31.6% to 41.9% (P = .006). The individual project group had no significant change. Nonparticipants had a decrease in PMA from 37.5 to 37.3 weeks (P = .01) but no significant change in early discharge (39.8% to 43.6%; P = .24). There was no significant change in readmissions over time in the collaborative group. CONCLUSIONS: A structured collaborative project that was focused on optimizing LOS led to a 3-day decrease in LOS and was more effective than individualized quality improvement efforts. |
| Databáze: | OpenAIRE |
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