NAS State Collaboratives

State Perinatal Program and Vermont Oxford Network

Adoption of the Vermont Oxford Network Universal Training Program (NAS) to Improve Care For Substance-Exposed Infants and Families

Background in Brief

Opioid use in pregnant women has escalated and resulted in a dramatic rise in the number of newborn infants who develop severe signs of opioid withdrawal. Standardizing care has the potential to both improve the quality and safety of care, but also to decrease unnecessary length of stay and associated costs to the health system. Medicaid bears the burden of the costs for newborns with opioid withdrawals; states that have systematically engaged in improvement efforts have demonstrated associated improved cost more

Dr. Mark Hudak has been engaged with VON in the rapid cycle dissemination of the current AAP Guidelines for NAS, as well as contributing to the test deployment of a Universal Training Program for Neonatal Abstinence Syndrome, testing this with 115 VON centers. To date these centers have enthusiastically embraced the VON Universal Training Program, completing over 50,000 micro-lessons. Fifteen centers have achieved a Center of Excellence in NAS Training and Education designation and have trained at least 85% of their interdisciplinary team members. Involvement in a multicenter quality improvement collaborative focused on infants with NAS was associated with increases in standardizing hospital patient care policies and guidelines and decreasing healthcare utilization. Further, it provides evidence for use of a novel model to promote rapid-cycle adoption of practice guidelines and associated cost savings. Using 2012 estimates reducing length of stay by two days nationally would result in savings.

Primary Project Goals

Our primary aim is the systematic rapid-cycle distribution of current evidence-based education and materials to the interdisciplinary workforce, who are engaged in caring for substance-exposed infants and families.

  1. Distribute current evidence-based education and materials to interdisciplinary state collaboratives engaged in caring for substance-exposed infants and families.
  2. Leverage NAS Universal Training Model to promote rapid-cycle uptake of potentially better practices and statewide improvement.
  3. Improve the quality, safety and value of care for this vulnerable population of infants and families.
  4. Explore the potential for your state to achieve the VON “State of Excellence” in NAS Training and Education by encouraging widespread adoption.