Monica H Wojcik1,2,3, Jenny Chan Yuen4, Anne Hansen4,5, Kristen T Leeman4,5. 1. Division of Genetics and Genomics, Boston, MA, USA. monica.wojcik@childrens.harvard.edu. 2. Division of Newborn Medicine, Boston, MA, USA. monica.wojcik@childrens.harvard.edu. 3. Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA. monica.wojcik@childrens.harvard.edu. 4. Division of Newborn Medicine, Boston, MA, USA. 5. Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.
Abstract
OBJECTIVE: Death certificates commonly contain errors, which hinders understanding of infant mortality. We, therefore, undertook a quality improvement (QI) initiative to improve death reporting in our neonatal intensive care unit (NICU). STUDY DESIGN: After our baseline assessment (January 1, 2015 to June 30, 2017), we implemented our QI initiatives using Plan, Do, Study, Act (PDSA) tests of change. We prospectively reviewed death certificates (July 1, 2017 to December 31, 2019) to evaluate the impact of our interventions. RESULTS: The overall proportion of incorrect death certificates significantly decreased from 71 to 22% with special cause variation noted after the second PDSA cycle. The most common errors involved inaccurate or incomplete reporting of prematurity and errors in the sequence of events. CONCLUSION: Through a series of PDSA cycles focused on formal provider education and ongoing review, we significantly reduced inaccurate death reporting. These interventions are generalizable across NICUs and important to improve public health reporting accuracy.
OBJECTIVE: Death certificates commonly contain errors, which hinders understanding of infant mortality. We, therefore, undertook a quality improvement (QI) initiative to improve death reporting in our neonatal intensive care unit (NICU). STUDY DESIGN: After our baseline assessment (January 1, 2015 to June 30, 2017), we implemented our QI initiatives using Plan, Do, Study, Act (PDSA) tests of change. We prospectively reviewed death certificates (July 1, 2017 to December 31, 2019) to evaluate the impact of our interventions. RESULTS: The overall proportion of incorrect death certificates significantly decreased from 71 to 22% with special cause variation noted after the second PDSA cycle. The most common errors involved inaccurate or incomplete reporting of prematurity and errors in the sequence of events. CONCLUSION: Through a series of PDSA cycles focused on formal provider education and ongoing review, we significantly reduced inaccurate death reporting. These interventions are generalizable across NICUs and important to improve public health reporting accuracy.
Authors: Lauri McGivern; Leanne Shulman; Jan K Carney; Steven Shapiro; Elizabeth Bundock Journal: Public Health Rep Date: 2017-11-01 Impact factor: 2.792
Authors: Monica H Wojcik; Talia S Schwartz; Katri E Thiele; Heather Paterson; Rachel Stadelmaier; Thomas E Mullen; Grace E VanNoy; Casie A Genetti; Jill A Madden; Cynthia S Gubbels; Timothy W Yu; Wen-Hann Tan; Pankaj B Agrawal Journal: J Perinatol Date: 2019-08-08 Impact factor: 2.521
Authors: Greg Ogrinc; Louise Davies; Daisy Goodman; Paul Batalden; Frank Davidoff; David Stevens Journal: BMJ Qual Saf Date: 2015-09-14 Impact factor: 7.035