Featured Research

Using the NICU Wisely: Creating more efficient and effective systems of care for infants and families.

Discharge Age and Weight for Very Preterm Infants: 2005–2018

Pediatrics, February 2021

A complex set of medical, social, and financial factors underlie decisions to discharge very preterm infants.

Analysis from member-submitted data in the VON Very Low Birth Weight Database, gestational age and weight at discharge increased steadily from 2005 to 2018 for survivors 24 to 29 weeks’ gestation. While there are undetermined causes, benefits, and costs of longer stays, the effect of separation from families should not be underestimated.

Authors: Erika M. Edwards, Lucy T. Greenberg, Danielle E.Y. Ehret, Scott A. Lorch and Jeffrey D. Horbar

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Variation in use by NICU types in the United States

Pediatrics, November 2018

There is a large variation in the proportions of NICU admissions, initial NICU hospitalization days, high-acuity cases, and short-stay cases by gestational age.

Analysis from member-submitted data of all NICU admissions in VON’s Expanded Database led to the question: Are we using the NICU wisely?

Authors: Erika M. EdwardsJeffrey D. Horbar

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Quality Improvement to Use the NICU Wisely

Improving processes and practices can affect NICU utilization, improve the family experience, and help teams develop integrated systems of newborn care that reflect local context and provide infants and families with the level and duration of care most appropriate to their needs. See how your center can participate in VON quality improvement.

Related Publications

Braun D, Edwards EM, Schulman J, Profit J, Pursley DM, Goodman DC. Choosing wisely for the other 80%: What we need to know about the more mature newborn and NICU care. Semin Perinatol 2021:151395. PubMed: 33573773.

Dukhovny D, Buus-Frank ME, Edwards EM, Ho T, Morrow KA, Srinivasan A, Pollock DA, Zupancic JAF, Pursley DM, Goldmann D, Puopolo KM, Soll RF, Horbar JD. A collaborative multicenter QI initiative to improve antibiotic stewardship in newborns. Pediatrics. 2019;144(6):e20190589. PubMed: 31676682

Patrick SW, Schumacher RE, Horbar JD, Buus-Frank ME, Edwards EM, Morrow KA, Ferrelli KR, Picarillo AP, Gupta M, Soll RF. Improving care for neonatal abstinence syndrome. Pediatrics. 2016; 137(5): e20153835. PubMed: 27244809

Dukhovny D, Pursley DM, Kirpalani HM, Horbar JH, Zupancic JAF. Evidence, quality, and waste: Solving the value equation in neonatology. Pediatrics. 2016; 137(3): e20150312. PubMed: 26908677

Ho T, Dukhovny D, Zupancic J.A.F., Goldmann DA, Horbar JD, Pursley DM. Choosing wisely in newborn medicine: five opportunities to increase value. Pediatrics. 2015;136(2): e482-9. PubMed: 26195536