A multidisciplinary quality improvement effort to reduce bronchopulmonary dysplasia incidence.,Journal of Perinatology

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A multidisciplinary quality improvement effort to reduce bronchopulmonary dysplasia incidence.
Journal of Perinatology ( IF 2.4 ) Pub Date : 2020-01-06 , DOI: 10.1038/s41372-019-0574-8
Roopali Bapat ₁ , Leif Nelin _{1,

2} , Edward Shepherd ₁ , Greg Ryshen ₃ , Amee Elgin ₃ , Thomas Bartman ₁

Affiliation

BACKGROUND Bronchopulmonary Dysplasia (BPD) is the most common prematurity complication. Although several practices have been proposed for BPD prevention, none of these in isolation prevent BPD. METHODS Our initiative focused on two key drivers: oxygen management and noninvasive ventilation strategies. We created best practice guidelines and followed outcome measures using Shewhart control charts. RESULTS PDSAs of protocols preceded a large-scale rollout of a "0.21 by 28" campaign in 2014 leading to a special cause reduction in the "any BPD" rate, and a decrease in severe BPD (from 57 to 29%). At the end of 2017, we reinvigorated the project, which led to dramatic decreases in the "any BPD" rate to 41% and the "severe BPD" rate to 21%. CONCLUSIONS A multidisciplinary QI initiative focused on process improvement geared towards the pathophysiological contributors of BPD has successfully reduced the rate of BPD in an all referral level IV NICU.

中文翻译：

为降低支气管肺发育不良发生率而进行的多学科质量改进工作。

背景技术支气管肺发育不良（BPD）是最常见的早产并发症。尽管已经提出了几种预防BPD的方法，但这些方法都不能单独预防BPD。方法我们的计划集中在两个主要驱动因素上：氧气管理和无创通气策略。我们创建了最佳实践准则，并使用Shewhart控制图遵循了结果度量。结果协议的PDSA在2014年大规模推出“ 0.21 x 28”运动之前，导致“任何BPD”发生率的特殊原因降低，严重BPD降低（从57％降至29％）。在2017年底，我们重新启动了该项目，这导致“任何BPD”率大幅降低至41％，“严重BPD”率降至21％。

更新日期：2020-01-06

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