The Ins and Outs of Neonatal Care: Improving Critical Transitions for Every Newborn Internet-based Quality Improvement Collaborative

About Vermont Oxford Network Vermont Oxford Network (VON) is the world leader in data-driven, evidence-based quality improvement in neonatal care. 30,000+ health care professionals at 1200+ hospitals 600+ centers participating in QI collaboratives over 25 years 1400+ health care professionals convene at the VON Annual Quality Congress Established record of improving quality, safety, and value of care through QI collaboratives, documented in hundreds of presented abstracts and peer-reviewed articles

Transitions Affect All Levels of Care Hospitals/Health Centers: Individual centers aiming to improve local transitions of care Referral Centers (Level III, IV): Working with referral base to improve both local and regional processes and build capacity for regional QI initiatives Health Systems: Improving intra- or inter-hospital transitions within a health system and region State Perinatal QI Organizations: Developing reliable systems for newborn care among and between hospitals using a population health perspective Level 1 Level 2 Level 3 Level 4 Systems & Networks

QI Collaborative for Critical Transitions Critical transitions represent a vulnerable period for infants and families; if not standardized and coordinated the potential for inefficient/ineffective care and excess length of stay exists. Transitions are ripe for improvement Every infant experiences critical transitions; improvement will affect every newborn and family The most vulnerable infants experience the most transitions VON data shows a frequency of inter-hospital transfers and increased length of stay Family satisfaction is low for short-stay NICU patients Patients with readmissions account for a significant proportion of admissions and inpatient charges Transitions are recognized as areas of improvement by the American Academy of Pediatrics, Agency for Healthcare Research and Quality, National Quality Forum, and The Joint Commission

Admission/Discharge and Handoffs Teams will focus on critical transitions of either: “Ins” (inborn admission/stabilization or transport) Maternal/Fetal Transport Antepartum Care Birth/Golden Hour OR “Outs” (transition home and follow-up/follow-through) Discharge Home Retrotransfer Medical Home Medical, Psychologic, Social, Developmental All teams will also improve handoffs Change of shift Change of care team/department Teams can further refine their focus by improving care of certain patient populations Infants requiring complex care at home Families affected by neonatal abstinence syndrome Late preterm infants Micro-premature infants Etc.

Local Need for Improvement Insert your own data from VON and/or results from the discernment exercise.

Expected Outcomes Improved clinical outcomes (BPD, ROP, IVH, NEC, extrauterine growth restriction) Reduced length of stay (saving 1 day for 1 patient equals the cost of participation) Reduced readmissions Reduced risk and errors Better patient and family engagement and satisfaction Better staff satisfaction and retention Improved reputation, ratings, and rankings (ie Press Ganey, Magnet Certification, US News & World Report)

Core Curriculum Data audits and gap analysis Toolkit focused on critical transitions and proven QI methodology Interactive webinars open to all hospital staff, and online access to recorded webinars Discussion board/listserv with other teams and expert faculty CME/CNE/CPE for entire team Maintenance of Certification (MOC) Part 4 for entire physician team submitting an abstract* Opportunity to share poster or podium presentation at VON’s 2019 Annual Quality Congress, and coaching to develop the abstract *abstract must meet American Board of Pediatrics criteria

Intensive Curriculum All benefits of the Core Curriculum Pre-paid attendance to Annual Quality Congress for 8 team members (more than $4800 value) VON/IHI Foundations in Improvement Science online course 3 additional webinars for experience-based co-design in partnership with families with curriculum provided in cooperation with the Point of Care Foundation.

Two Levels of Participation Core Curriculum $3900 (VON Member) $6900 (Non-Member) Intensive Curriculum $6900 (VON Member) $9400 (Non-Member) Group Enrollment A 20% discount is granted to Level III NICUs enrolling as a member of a statewide group, regional quality improvement collaborative, or a health system-wide enrollment. Recruit Level I and Level II hospitals to engage in your efforts with a nominal registration fee of $500 per center.

Learn More and Register Pam Ford, iNICQ Coordinator 802.865.4814 ext. 204 inicq@vtoxford.org www.vtoxford.org