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Implementation methods for delivery room management: a quality improvement comparison study.

CPQCC Publication
TitleImplementation methods for delivery room management: a quality improvement comparison study.
Publication TypeJournal Article
Year of Publication2014
AuthorsLee HC, Powers RJ, Bennett MV, Finer NN, Halamek LP, Nisbet C, Crockett M, Chance K, Blackney D, von Köhler C, Kurtin P, Sharek PJ
Date Published2014 Nov
KeywordsAdult, Cohort Studies, Delivery Rooms, Delivery, Obstetric, Female, Humans, Infant, Newborn, Longitudinal Studies, Male, Pregnancy, Prospective Studies, Quality Improvement

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.

Alternate JournalPediatrics
PubMed ID25332503
PubMed Central IDPMC4210793
Grant ListK23 HD068400 / HD / NICHD NIH HHS / United States
K23HD068400 / HD / NICHD NIH HHS / United States