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Clinical Process Improvement: Reduction of Pneumothorax and Mortality in High-Risk Preterm Infants

Journal of Perinatology volume 22, pages 641–645 (2002)Cite this article

Abstract

OBJECTIVE: To develop multidisciplinary clinical process improvement methods using evidence-based medicine to decrease the incidence of pneumothorax in a NICU.

STUDY DESIGN: All inborn infants <28 weeks' gestation (n=79) served as the historical baseline group. A prospective protocol, using evidence-based medicine and a rapid-cycle, multidisciplinary clinical process improvement method, was designed to measure changes in the incidence of pneumothorax in subsequent infants of similar gestational ages.

RESULTS: Sixty consecutive inborn infants <28 weeks' gestational age comprised the study group. In comparison to the historical control group, there was a significant reduction in the incidence of pneumothorax (from 26.6% to 10%, p=0.018) and in mortality (36.7% to 15%, p=0.007) without adversely affecting any other measured outcome variable.

CONCLUSIONS: Introduction of multidisciplinary clinical process improvement methods can significantly decrease the incidence of adverse outcomes in neonatal intensive care units.

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Authors and Affiliations

  1. The Children's Hospital, Greenville Hospital System, Greenville, SC, USA

    M Whit Walker MD, Mike Shoemaker RRT, Kim Riddle RRT & Martin M Crane PhD

  2. The Pediatrix–Obstetrix Center for Research and Education, Pediatrix Medical Group, Inc., Sunrise, FL, USA

    Reese Clark MD

Authors
  1. M Whit Walker MD
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  2. Mike Shoemaker RRT
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  3. Kim Riddle RRT
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  4. Martin M Crane PhD
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  5. Reese Clark MD
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Walker, M., Shoemaker, M., Riddle, K. et al. Clinical Process Improvement: Reduction of Pneumothorax and Mortality in High-Risk Preterm Infants. J Perinatol 22, 641–645 (2002). https://doi.org/10.1038/sj.jp.7210786

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