Multifaceted CQI Program Results in Improved Neonatal Outcomes
MEDNAX, Inc. (NYSE: MD) today announced that the results of its
Continuous Quality Improvement (CQI) program, the “100,000 Babies
Campaign,” has been published in Pediatrics, the official journal
of the American Academy of Pediatrics (AAP). This is one of more than
100 peer-reviewed clinical studies by MEDNAX clinicians that have
resulted in improvements in neonatal health care, many on a national
scale.
The study, “A
Multifaceted Approach to Improving Outcomes in the NICU: The 100,000
Babies Campaign,” was authored by a multi-disciplinary
team from MEDNAX’s Center for Research, Education and Quality who
developed and led the campaign in hospital neonatal intensive care units
(NICUs) across the country. The 100,000 Babies Campaign focused on five
critical clinical practices and procedures used in neonatal care:
enhancing nutrition, improving medication use, reducing central line
infections, minimizing mechanical ventilation and reducing suboptimal
admission temperatures.
From 2007 to 2013, the CQI program was directly associated with
simultaneous improvement in processes and patient outcomes. Specifically:
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The campaign resulted in the increased use of human breast milk and
the decreased use of commonly overused medications.
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In very low birth weight infants, mortality decreased by 22 percent.
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Necrotizing enterocolitis decreased by 41 percent.
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Severe retinopathy of prematurity decreased by 31 percent.
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Late onset infection decreased by 54 percent.
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Central line infections decreased by 56 percent.
These improvements in processes and patient outcomes can have
significant cost implications as well. For example, the authors estimate
that the decrease in central line infections over the study period
reflected a cumulative cost reduction of $58 million.
Organizational change and large-scale
improvements
The study itself not only focuses on the improved outcomes, but how
organizational change theory, automated electronic health record (EHR)
based data collection and reporting can enable simultaneous improvements
in neonatal care processes and patient outcomes. According to the
study’s lead author, Dan Ellsbury M.D., the objective of the 100,000
Babies Campaign was to reengineer the delivery of neonatal intensive
care in a large neonatal network, with the goal of simultaneous and
multi-dimensional improvements in processes and outcomes.
“Quality improvement collaboratives commonly focus on a single clinical
problem or morbidity, rather than groups of problems requiring extensive
data collection,” explains Dr. Ellsbury. “We believe that use of
organizational change theory, automated collection of specialty-specific
data and targeting key drivers of adverse health outcomes can result in
large-scale organizational change, improved patient health and
ultimately the improved value of clinical care.”
Today MEDNAX providers care for nearly 110,000 neonatal patients in the
country per year. With access to this large network of NICUs,
de-identified study data was gathered on more than 420,000 babies from
2007 to 2013 at 330 NICUs. Data was compiled using BabySteps, the
company’s proprietary EHR system and transferred into the MEDNAX
clinical data warehouse (CDW), one of the nation’s most robust NICU
databases.
“In this study, our physicians actually had the ability to see and
compare their own data and outcomes against other NICUs and facilitate
change. Collaborative environments like this, as well as through our
frequent quality summits and annual clinical conferences make
large-scale improvements possible,” adds Dr. Alan Spitzer, co-author.
A health solutions partner in neonatal care
The benefits of the 100,000 Babies Campaign are being recognized by
MEDNAX’s hospital and health system partners across the country.
Participating hospitals reported improved quality of care offered to
women and their babies in the local communities; improved long-term
outcomes and parent satisfaction; enhanced collaboration, communication,
knowledge-sharing and interdisciplinary relationships amongst all
members of the NICU team; and demonstrated commitment to quality
improvement, as well as patient-safety and cost-efficient care.
“The 100,000 Babies Campaign is a multi-disciplinary effort, therefore,
the entire NICU team of clinicians within a participating hospital are
fully committed and willing to participate in the quality improvement
process,” notes Dr. Robert Ursprung, co-author. “Through this team
approach, lines of communication are strengthened by continuous
interaction between physicians and nurses. It’s truly a win-win for
everyone involved, and we celebrate all of the providers who have made
this effort a success.”
Early release of the study can be seen here: http://pediatrics.aappublications.org/content/early/2016/02/29/peds.2015-0389
A Multifaceted Approach to Improving Outcomes in the NICU: The 100,000
Babies Campaign
Dan L. Ellsbury, M.D., Reese H. Clark, M.D., Robert Ursprung, M.D.,
MMSc, Darren L. Handler, B.S., Elizabeth D. Dodd, B.A., and Alan R.
Spitzer, M.D.
Pediatrics; published online March 2, 2016; DOI:
10.1542/peds.2015-0389
ABOUT MEDNAX:
MEDNAX, Inc. is a national medical group comprised of the nation's
leading providers of physician services. Physicians and advanced
practitioners practicing as part of MEDNAX are reshaping the delivery of
care within their specialties and subspecialties, using evidence-based
tools, continuous quality initiatives, clinical research and
telemedicine to enhance patient outcomes and provide high-quality,
cost-effective care. The Company was founded in 1979, and today, through
its affiliated professional corporations, MEDNAX provides services
through a network of more than 3,275 physicians in all 50 states and
Puerto Rico. In addition to its national physician network, MEDNAX
provides services to healthcare facilities and physicians in over 40
states through two complementary businesses, consisting of a revenue
cycle management company and a consulting services company. Additional
information is available at www.mednax.com.
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