The Ins and Outs of Neonatal Care

Frequently Asked Questions

What is the Global Aim of this QI Collaborative?
This collaborative will assist teams in increasing shared definition of “critical transitions” and mutual accountability in the system to assure that “critical transitions” of care for every newborn are:

  • Safe
  • Timely
  • Efficient
  • Effective
  • Equitable
  • Patient and Family Centered
  • Socially Responsible

(based on the Institute of Medicine STEEEPS criteria)

Why Focus on Transitions in Care?

New VON transfer data suggest that patients frequently experience one or more intra-hospital transfers during their inpatient stay. Further, an analysis of recent trends indicates significant increases in LOS across all gestational age / birthweight classes in the network.

We believe that a deep dive into critical transitions at your center and  learning from other hospitals around the world will result in increased efficiency, improved family satisfaction, and improved quality of care for all infants at your center. Focusing on critical transitions VON expert faculty will provide the expertise, coaching and disciplined quality improvement tools to assist the multi-disciplinary clinical care team to co-design care, in concert with families’ preferences and to achieve measurable improvements in care.

What Outcomes Will We Achieve?

In partnership with parents we can implement potentially better practices and we anticipate the following measurable results:

  • Identifying and decreasing potentially preventable NICU admissions
  • Decrease an excess length of stay (and length of separation from families)
  • Avoid hospital readmissions
  • Improve patient and family engagement in and satisfaction with care
  • Avoid patent injury / error related to poor care coordination or communication
  • Improve follow-up and follow-through rates

What is a Critical Transition?

Any change in an infant’s site of care, change in their status or plan of care, or a change in the infant’s care team is defined as a critical transition.

Some transitions of care occur within a hospital or health system; others occur between hospitals and communities. Teams will begin in year 1 by focusing on critical transitions of admission and transition home as well as handoffs throughout the phases of care. Learn more about critical transitions.

Who Should Join?

Any center interested in improving critical transitions can and should join. This multi-center, international quality improvement collaborative will also have an emphasis on regional partnerships. It is designed for:

  • Hospitals/Health Centers: Individual centers aiming to improve local transitions of care
  • Referral Centers (Level III, IV): Working in close partnership with referral base of Level I and Level II centers to improve both local and regional processes and build capacity for regional QI initiatives
  • Health Systems: Improving intra- or inter-hospital transitions within a health system and region
  • State Perinatal QI Organizations: Developing reliable systems for newborn care among and between hospitals using a population health perspective

Is it Possible to Continue our NAS or Antibiotic Stewardship Work Using the New Critical Transitions Framework?

Yes! Teams working on “ins” and/or “outs” have the option to focus their QI work on specific populations such as late preterm infants, micro-premature infants,  infants with NAS, etc.

What is the Role of Children’s Hospitals in this Project?

Every day over 20,000 infants in the US make the potentially risks transition from the NICU to a PCP whom them have never met!  Infants requiring complex medical care have magnified vulnerability; Nearly 19% of admissions to children’s hospitals, and 23% of their inpatient charges, can be attributed to a small subset (3%) of medically complex and fragile infants who have multiple hospital admissions often for the same pre-existing organ system dysfunction or problem.

We expect that children’s hospitals, who care for the most complex patients, will have a unique opportunity and obligation to lead the way in improving critical transitions for patients in their region. Many tertiary and quaternary children’s hospitals and/or health systems are already planning to use the critical transitions project to collaborate across their health system and co-design optimal transitions of care.

What Are the Benefits to Our Organization?

The 2019 – Ins and Outs: Critical Transitions collaborative will allow your organization to:

  • Participate collaboratively with expert faculty and colleagues around the world to demonstrate measurable improvement in care.
  • Learn from world-class experts both on live webinars and in the 24/7 online classrooms
  • Develop, test, and implement and evaluate best practices using disciplined QI methods.
  • Access resources online 24/7 to include Toolkit developed by QI experts and real-world examples of improvement from leading teams demonstrating results
  • Participate in focused VON Day Audits designed to provide baseline gap analysis and to track progress of key measures over time
  • Participate in online course developed in partnership with the IHI, Practical Foundations in Improvement Science (included in Intensive curriculum, optional upgrade for Core curriculum)
  • Earn continuing education credits towards certification and MOC Part 4 credit for qualifying physicians

Intensive-level Participants Gain Additional Benefits:

  • All elements of Core Curriculum
  • Fundamentals in Quality Improvement curriculum for entire team
  • Three “deeper dive” live webinars
  • Dynamic face-to-face collaboration at our Annual Quality Congress and Quality Improvement Symposium

Is There a Cost to Join?

Please click here for pricing information, including discounts for members of statewide groups, regional quality improvement collaboratives, or a health system-wide enrollment.