Integrating Implementation Science with Quality Improvement to Improve Perinatal Outcomes
Implementation science is an interdisciplinary field that seeks to contribute generalizable knowledge that can improve the translation of clinical evidence in routine care. To promote the integration of implementation science approaches with health care quality improvement, the authors offer a framework that links the Model for Improvement with implementation strategies and methods. Perinatal quality improvement teams can leverage the robust frameworks of implementation science to diagnose implementation barriers, select implementation strategies, and assess the strategies ’ contribution to improving care. Partnerships b...
Source: Clinics in Perinatology - March 27, 2023 Category: Perinatology & Neonatology Authors: Jennifer Callaghan-Koru, Azadeh Farzin, Erick Ridout, Geoffrey Curran Source Type: research
The Evolution of Neonatal Patient Safety
Human factors science teaches us that patient safety is achieved not by disciplining individual health care professionals for mistakes, but rather by designing systems that acknowledge human limitations and optimize the work environment for them. Incorporating human factors principles into simulation, debriefing, and quality improvement initiatives will strengthen the quality and resilience of the process improvements and systems changes that are developed. The future of patient safety in neonatology will require continued efforts to engineer and re-engineer systems that support the humans who are at the interface of deliv...
Source: Clinics in Perinatology - March 27, 2023 Category: Perinatology & Neonatology Authors: Nicole K. Yamada, Louis P. Halamek Source Type: research
How Design Thinking and Quality Improvement Can Be Integrated into a “Human-Centered Quality Improvement” Approach to Solve Problems in Perinatology
Both quality improvement (QI) and design thinking (DT) methodologies have their unique strengths and weaknesses. Although QI sees problems through a process-centered lens, DT leverages a human-centered approach to understand how people think, behave, and act when encountering a problem. By integrating these 2 frameworks, clinicians have a unique opportunity to rethink how to solve problems in health care by elevating the human experience and putting empathy back at the center of medicine. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - March 27, 2023 Category: Perinatology & Neonatology Authors: Jessica Gaulton, Byron Crowe, Jules Sherman Source Type: research
Using Quality Improvement to Improve Value and Reduce Waste
Value is defined as health outcomes achieved per dollar spent. Addressing value in quality improvement (QI) efforts can help optimize patient outcomes while reducing unnecessary spending. In this article, we discuss how QI focused on reducing morbidities frequently reduces costs, and how proper cost accounting can help demonstrate improvements in value. We provide examples of high-yield opportunities for value improvement in neonatology and review the literature associated with these topics. Opportunities include reducing neonatal intensive care admissions for low-acuity infants, sepsis evaluations in low-risk infants, unn...
Source: Clinics in Perinatology - March 27, 2023 Category: Perinatology & Neonatology Authors: Brian King, Ravi M. Patel Source Type: research
Recent Progress in Neonatal Global Health Quality Improvement
Quality improvement methodologies, coupled with basic neonatal resuscitation and essential newborn care training, have been shown to be critical ingredients in improving neonatal mortality. Innovative methodologies, such as virtual training and telementoring, can enable the mentorship and supportive supervision that are essential to the continued work of improvement and health systems strengthening that must be done after a single training event. Empowering local champions, building effective data collection systems, and developing frameworks for audits and debriefs are among the strategies that will create effective and h...
Source: Clinics in Perinatology - March 27, 2023 Category: Perinatology & Neonatology Authors: Ashish KC, Rohit Ramaswamy, Danielle Ehret, Bogale Worku, Beena D. Kamath-Rayne Source Type: research
Challenging Cases in Statistical Process Control for Quality Improvement in Neonatal Intensive Care
This article reviews these situations and provides examples of SPC approaches for each. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - March 27, 2023 Category: Perinatology & Neonatology Authors: Munish Gupta, Lloyd P. Provost, Heather C. Kaplan Source Type: research
A Tipping Point for Quality Improvement in Neonatal Intensive Care
It has now been more than 20 years since the Institute of Medicine ’s landmark reports “To Err is Human” and “Crossing the Quality Chasm,” often considered the unofficial launch of the modern movement in health care safety and quality. It has been 5 years since Clinics in Perinatology last devoted an issue to Quality Improvement (QI) in neonatology. Are w e making progress? (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - March 22, 2023 Category: Perinatology & Neonatology Authors: Munish Gupta, Heather C. Kaplan Tags: Preface Source Type: research
Sustaining Improvement Initiatives: Challenges and Potential Tools
Like many implemented organizational changes, quality improvement (QI) projects demonstrate frequent decline after implementation. Factors associated with successfully sustained change are leadership, change characteristics, system capacity for changes and the resources required, and processes to maintain, evaluate, and communicate results. This review uses lessons from change theory and behavioral sciences to discuss change and sustainment of improvement efforts, to list models to support maintenance, and to provide evidence-based practical suggestions to enable the sustainability of QI interventions. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - March 20, 2023 Category: Perinatology & Neonatology Authors: Asaph Rolnitsky, Chaim M. Bell Source Type: research
Developing a Respiratory Quality Improvement Program to Prevent and Treat Bronchopulmonary Dysplasia in the Neonatal Intensive Care Unit
This article presents a potential framework for developing a quality improvement program to prevent bronchopulmonary dysplasia in the NICU. Drawing on available research and quality improvement reports, the authors discuss key components, measures, drivers, and interventions that should be considered when building a respiratory quality improvemen t program devoted to preventing and treating bronchopulmonary dysplasia. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - March 20, 2023 Category: Perinatology & Neonatology Authors: Lauren A. Sanlorenzo, Leon Dupree Hatch Source Type: research
Improving Neonatal Intensive Care Unit Quality and Safety with Family-Centered Care
There is strong evidence that family-centered care (FCC) improves the health and safety of infants and families in neonatal settings. In this review, we highlight the importance of common, evidence-based quality improvement (QI) methodology applied to FCC and the imperative to engage in partnership with neonatal intensive care unit (NICU) families. To further optimize NICU care, families should be included as essential team members in all NICU QI activities, not only FCC QI activities. Recommendations are provided for building inclusive FCC QI teams, assessing FCC, creating culture change, supporting health-care practition...
Source: Clinics in Perinatology - March 20, 2023 Category: Perinatology & Neonatology Authors: Linda S. Franck, Anna Axelin, Nicole R. Van Veenendaal, Fabiana Bacchini Source Type: research
The Electronic Health Record as a Quality Improvement Tool
The electronic health record (EHR) offers an exciting opportunity for quality improvement efforts. An understanding of the nuances of a site ’s EHR landscape including the best practices in clinical decision support design, basics of data capture, and acknowledgment of the potential unintended consequences of technology change is essential to ensuring effective usage of this powerful tool. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - March 20, 2023 Category: Perinatology & Neonatology Authors: Leah H. Carr, Lori Christ, Daria F. Ferro Source Type: research
Measuring Equity for Quality Improvement
Applying an equity lens to quality improvement (QI) by collecting, reviewing, and using data that measure health disparities helps identify whether QI interventions improve outcomes evenly and equally across the population or have a greater impact in an advantaged or disadvantaged group. Methodological issues inherent in measuring disparities include appropriately selecting data sources; ensuring reliability and validity of equity data; choosing a suitable comparison group; and understanding between-group variation. The integration and utilization of QI techniques to promote equity is dependent on meaningful measurement to...
Source: Clinics in Perinatology - March 20, 2023 Category: Perinatology & Neonatology Authors: Nina Menda, Erika Edwards Source Type: research
All Care is Brain Care
Neonates requiring intensive care are in a critical period of brain development that coincides with the neonatal intensive care unit (NICU) hospitalization, placing these infants at high risk of brain injury and long-term neurodevelopmental impairment. Care in the NICU has the potential to be both harmful and protective to the developing brain. Neuro-focused quality improvement efforts address 3 main pillars of neuroprotective care: prevention of acquired injury, protection of normal maturation, and promotion of a positive environment. Despite challenges in measurement, many centers have shown success with consistent imple...
Source: Clinics in Perinatology - March 9, 2023 Category: Perinatology & Neonatology Authors: Melissa Liebowitz, Katelin P. Kramer, Elizabeth E. Rogers Source Type: research
Outcomes of Preterm Infants
This article reviews the broader context of follow-up care, highlighting the need to reenvision some areas, such as improving parental support by embedding parental involvement in the neonatal intensive care unit, incorporating parental perspectives about outcomes into follow-up care models and research, supporting their mental health, addressing social determinants of health and disparities, and advocating for change. Multicenter quality improvement networks allow identification and implementation of best practices for follow-up care. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - March 1, 2023 Category: Perinatology & Neonatology Authors: Susan R. Hintz, Raye-Ann deRegnier, Betty R. Vohr Source Type: research
Neurodevelopmental Outcomes in Children with Congenital Heart Disease
Even before birth, children with congenital heart disease (CHD) are at risk for neurodevelopmental concerns, with additional insults occurring as part of their treatment course and from subsequent exposures to socioeconomic stressors. With multiple affected neurodevelopmental domains, individuals with CHD face lifelong cognitive, academic, psychological, and quality-of-life difficulties. Early and repeated neurodevelopmental evaluation is key to receiving appropriate services. However, obstacles at the level of the environment, provider, patient, and family can make the completion of these evaluations difficult. Future neu...
Source: Clinics in Perinatology - March 1, 2023 Category: Perinatology & Neonatology Authors: Trisha Patel, Dawn Ilardi, Lazaros Kochilas Source Type: research
