VON for Health Equity

VON teams act on our ethical responsibility to follow through for infants and families.

Social determinants

What does it mean to follow through?

Health and well being are largely determined by race, ethnicity, income, immigration status, and local neighborhood. The effects are pronounced for infants in NICU care.

There is much that we can and must do to address the social determinants of health.

“Follow through” is a comprehensive approach that begins before birth and continues into childhood involving health professionals, families, and communities as partners to meet the social as well as medical needs of infants and families.

VON teams are dedicated to follow through to address the social determinants of health with the same energy and expertise that we devote to the technical aspects of care.

See Potentially Better Practices for Follow Through

Potentially Better Practices for Follow Through

These Potentially Better Practices for Follow Through are intended as a starting point for individuals and teams. They vary greatly in ease of implementation and potential cost and we encourage you to start with change ideas that make the most sense for your unit. Go to the Potentially Better Practices for Follow Through

2019 Annual Quality Congress

Interactive Events and Recorded Videos

Our community held a virtual discussion to explore how COVID-19 is affecting the care of minority women and their infants and discuss steps that perinatal and newborn care teams can take to achieve health equity for the mothers, infants, and families we serve.

Our “Color of Health” sessions from the 2019 Annual Quality Congress are available on the VON Improvement Library.

View the Health Equity in the Age of Covid Recording
key drivers

Health Equity is a Key Driver for High Quality Critical Transitions

A critical transition is any change to the site of care, status or plan of care, or care team.

In newborn care, these changes happen multiple times from birth to home, and frequently through each phase of care. Each transition can affect the outcome of the infant and experience of the family.

Improvement in critical transitions is driven by:

  • Teamwork
  • Communication
  • Families as partners (including Experience-Based Co-Design)
  • Health Equity
  • QI Fundamentals (including standardization)

VON Quality Circle members participating in QI collaboratives take a structured and evidence-based approach to improvement of practices and processes during critical transitions, including incorporating VON Potentially Better Practices for Follow Through.

Quality Circle Membership and Collaboratives for Critical Transitions

Related Research

Beck AF, Edwards EM, Horbar JD, Howell EA, McCormick MC, Pursley DM. The color of health: how racism, segregation, and inequality affect the health and well-being of preterm infants and their families. Pediatr Res. 2019; epub ahead of print. PubMed: 31357209Open access.

Horbar JD, Edwards EM, Greenberg LT, Profit J, Draper D, Helkey D, Lorch SA, Lee HC, Phibbs CS, Rogowski J, Gould JB, Firebaugh G. Racial segregation and inequality in the neonatal intensive care unit for very low-birth-weight and very preterm infants. JAMA Pediatr. 2019; epub ahead of print. PubMed: 30907924

Boghossian NS, Geraci M, Lorch SA, Phibbs CS, Edwards EM, Horbar JD. Racial and ethnic differences over time in outcomes of infants born less than 30 weeks’ gestation. Pediatrics. 2019 Aug 12; epub ahead of print. PubMed: 31405887.

Parker MG, Greenberg LT, Edwards EM, Ehret D, Belfort MB, Horbar JD. National trends in the provision of human milk at hospital discharge among very low-birth-weight infants. JAMA Pediatr. 2019 Sept 3; epub ahead of print. PubMed: 31479097.

Sigurdson K, Morton C, Mitchell B, Profit J. Disparities in NICU quality of care: a qualitative study of family and clinician accounts. J Perinatol. 2018;38(5):600-607. PubMed: 29622778

Lake ET, Staiger D, Edwards EM, Smith JG, Rogowski JA. Nursing care disparities in neonatal intensive care units. Health Services Research. 2017 Sept 14; Epub ahead of print. PubMed: 28905367

Lake ET, Staiger D, Horbar J, Kenny MJ, Patrick T, Rogowski JA. Disparities in perinatal quality outcomes for very low birth weight infants in neonatal intensive care. Health Serv Res. 2015;50(2):374-397. PubMed: 25250882

Morales LS, Staiger DO, Horbar JD, Carpenter J, Kenny M, Geppert J, Rogowski J. Mortality among very low birthweight infants in hospitals serving minority population. Am J Public Health. 2005;95(12): 2206-2212. PubMed: 16304133