Multifaceted CQI Program Results in Improved Neonatal Outcomes

FORT LAUDERDALE, Fla.--(BUSINESS WIRE)--Mar. 2, 2016-- MEDNAX, Inc. (NYSE: MD) today announced that the results of its Continuous Quality Improvement (CQI) program, the “100,000 Babies Campaign,” has been published in Pediatrics, the official journal of the American Academy of Pediatrics (AAP). This is one of more than 100 peer-reviewed clinical studies by MEDNAX clinicians that have resulted in improvements in neonatal health care, many on a national scale.

The study, “A Multifaceted Approach to Improving Outcomes in the NICU: The 100,000 Babies Campaign,” was authored by a multi-disciplinary team from MEDNAX’s Center for Research, Education and Quality who developed and led the campaign in hospital neonatal intensive care units (NICUs) across the country. The 100,000 Babies Campaign focused on five critical clinical practices and procedures used in neonatal care: enhancing nutrition, improving medication use, reducing central line infections, minimizing mechanical ventilation and reducing suboptimal admission temperatures.

From 2007 to 2013, the CQI program was directly associated with simultaneous improvement in processes and patient outcomes. Specifically:

• The campaign resulted in the increased use of human breast milk and the decreased use of commonly overused medications.
• In very low birth weight infants, mortality decreased by 22 percent.
• Necrotizing enterocolitis decreased by 41 percent.
• Severe retinopathy of prematurity decreased by 31 percent.
• Late onset infection decreased by 54 percent.
• Central line infections decreased by 56 percent.

These improvements in processes and patient outcomes can have significant cost implications as well. For example, the authors estimate that the decrease in central line infections over the study period reflected a cumulative cost reduction of $58 million.

Organizational change and large-scale improvements

The study itself not only focuses on the improved outcomes, but how organizational change theory, automated electronic health record (EHR) based data collection and reporting can enable simultaneous improvements in neonatal care processes and patient outcomes. According to the study’s lead author, Dan Ellsbury M.D., the objective of the 100,000 Babies Campaign was to reengineer the delivery of neonatal intensive care in a large neonatal network, with the goal of simultaneous and multi-dimensional improvements in processes and outcomes.

“Quality improvement collaboratives commonly focus on a single clinical problem or morbidity, rather than groups of problems requiring extensive data collection,” explains Dr. Ellsbury. “We believe that use of organizational change theory, automated collection of specialty-specific data and targeting key drivers of adverse health outcomes can result in large-scale organizational change, improved patient health and ultimately the improved value of clinical care.”

Today MEDNAX providers care for nearly 110,000 neonatal patients in the country per year. With access to this large network of NICUs, de-identified study data was gathered on more than 420,000 babies from 2007 to 2013 at 330 NICUs. Data was compiled using BabySteps, the company’s proprietary EHR system and transferred into the MEDNAX clinical data warehouse (CDW), one of the nation’s most robust NICU databases.

“In this study, our physicians actually had the ability to see and compare their own data and outcomes against other NICUs and facilitate change. Collaborative environments like this, as well as through our frequent quality summits and annual clinical conferences make large-scale improvements possible,” adds Dr. Alan Spitzer, co-author.

A health solutions partner in neonatal care

The benefits of the 100,000 Babies Campaign are being recognized by MEDNAX’s hospital and health system partners across the country. Participating hospitals reported improved quality of care offered to women and their babies in the local communities; improved long-term outcomes and parent satisfaction; enhanced collaboration, communication, knowledge-sharing and interdisciplinary relationships amongst all members of the NICU team; and demonstrated commitment to quality improvement, as well as patient-safety and cost-efficient care.

“The 100,000 Babies Campaign is a multi-disciplinary effort, therefore, the entire NICU team of clinicians within a participating hospital are fully committed and willing to participate in the quality improvement process,” notes Dr. Robert Ursprung, co-author. “Through this team approach, lines of communication are strengthened by continuous interaction between physicians and nurses. It’s truly a win-win for everyone involved, and we celebrate all of the providers who have made this effort a success.”

Early release of the study can be seen here: http://pediatrics.aappublications.org/content/early/2016/02/29/peds.2015-0389

A Multifaceted Approach to Improving Outcomes in the NICU: The 100,000 Babies Campaign

Dan L. Ellsbury, M.D., Reese H. Clark, M.D., Robert Ursprung, M.D., MMSc, Darren L. Handler, B.S., Elizabeth D. Dodd, B.A., and Alan R. Spitzer, M.D.

Pediatrics; published online March 2, 2016; DOI: 10.1542/peds.2015-0389

ABOUT MEDNAX:

MEDNAX, Inc. is a national medical group comprised of the nation's leading providers of physician services. Physicians and advanced practitioners practicing as part of MEDNAX are reshaping the delivery of care within their specialties and subspecialties, using evidence-based tools, continuous quality initiatives, clinical research and telemedicine to enhance patient outcomes and provide high-quality, cost-effective care. The Company was founded in 1979, and today, through its affiliated professional corporations, MEDNAX provides services through a network of more than 3,275 physicians in all 50 states and Puerto Rico. In addition to its national physician network, MEDNAX provides services to healthcare facilities and physicians in over 40 states through two complementary businesses, consisting of a revenue cycle management company and a consulting services company. Additional information is available at www.mednax.com.

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Source: MEDNAX, Inc.

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