OBJECTIVE: To develop multidisciplinary clinical process improvement methods using evidence-based medicine to decrease the incidence of pneumothorax in a NICU. STUDY DESIGN: All inborn infants <28 weeks' gestation (n=79) served as the historical baseline group. A prospective protocol, using evidence-based medicine and a rapid-cycle, multidisciplinary clinical process improvement method, was designed to measure changes in the incidence of pneumothorax in subsequent infants of similar gestational ages. RESULTS: Sixty consecutive inborn infants <28 weeks' gestational age comprised the study group. In comparison to the historical control group, there was a significant reduction in the incidence of pneumothorax (from 26.6% to 10%, p=0.018) and in mortality (36.7% to 15%, p=0.007) without adversely affecting any other measured outcome variable. CONCLUSIONS: Introduction of multidisciplinary clinical process improvement methods can significantly decrease the incidence of adverse outcomes in neonatal intensive care units.
OBJECTIVE: To develop multidisciplinary clinical process improvement methods using evidence-based medicine to decrease the incidence of pneumothorax in a NICU. STUDY DESIGN: All inborn infants <28 weeks' gestation (n=79) served as the historical baseline group. A prospective protocol, using evidence-based medicine and a rapid-cycle, multidisciplinary clinical process improvement method, was designed to measure changes in the incidence of pneumothorax in subsequent infants of similar gestational ages. RESULTS: Sixty consecutive inborn infants <28 weeks' gestational age comprised the study group. In comparison to the historical control group, there was a significant reduction in the incidence of pneumothorax (from 26.6% to 10%, p=0.018) and in mortality (36.7% to 15%, p=0.007) without adversely affecting any other measured outcome variable. CONCLUSIONS: Introduction of multidisciplinary clinical process improvement methods can significantly decrease the incidence of adverse outcomes in neonatal intensive care units.
Authors: Barry M Lester; Robin J Miller; Katheleen Hawes; Amy Salisbury; Rosemarie Bigsby; Mary C Sullivan; James F Padbury Journal: Semin Perinatol Date: 2011-02 Impact factor: 3.300
Authors: Dan Waisman; Anna Faingersh; Carmit Levy; Ifat Colman-Klotzman; Avi Rotschild; Oscar Lichtenstein; Amir Landesberg Journal: Intensive Care Med Date: 2012-11-21 Impact factor: 17.440