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
No equity without quality

Health Equity Innovation Grant

To help teams follow through, VON is offering a competitive grant program for members to develop innovative examples that will spread through our community of practice.

Funded teams should expect to present their project at the Annual Quality Congress and to work with VON to disseminate their efforts and to collect metrics for evaluation.

Take Action to Follow Through Grant

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

Presentations and Videos

The State of Our Network – The Next Challenge: Following Through, Jeffrey Horbar

From 2019 VON Annual Quality Congress “Color of Health” sessions.

Watch in the VON Improvement Library

The Color of Law: How Our Government Segregated America, Richard Rothstein

From 2019 VON Annual Quality Congress “Color of Health” sessions.

Watch in the VON Improvement Library

Healthcare Crisis for Mothers and Babies of Color, Elizabeth Howell

From 2019 VON Annual Quality Congress “Color of Health” sessions.

Watch in the VON Improvement Library

Practical Interventions to Address Racial/Ethnic Inequity, Yolanda Ogbolu

From 2019 VON Annual Quality Congress “Color of Health” sessions.

Watch in the VON Improvement Library

The Color of Health - Our Story, Natasha Beauchamp and Marquita Turner

From 2019 VON Annual Quality Congress “Color of Health” sessions.

Watch in the VON Improvement Library

Health Equity in the Age of Covid: Lessons from the Pandemic

Explore how COVID-19 affects the care of minority women and infants, including steps care teams can take to achieve health equity.

Watch the Recorded Webinar

Related Publications

Edwards EM, Greenberg LT, Profit J, Draper D, Helkey D, Horbar JD. Quality of care in US NICUs by race and ethnicity. Pediatrics. 2021;148(2):e2020037622. doi: 10.1542/peds.2020-037622. Epub 2021 Jul 22. PubMed: 34301773

Edwards EM, Horbar JD. Following through: Interventions to improve long-term outcomes of preterm infants. Semin Perinatol. 2021 Mar 21:151414. Epub ahead of print. PubMed: 33853737.

Horbar JD, Edwards EM, Ogbolu Y. Our responsibility to follow through for NICU infants and their families. Pediatrics. 2020;146(6):e20200360. PubMed: 32546582

Boghossian NS, Geraci M, Edwards EM, Ehret DEY, Saade GR, Horbar JD. Regional and racial-ethnic differences in perinatal interventions  among periviable births. Obstet Gynecol. 2020;135(4):885-895. PubMed: 32168210

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

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