Researchers Find “Micro Preemie” Infant Outcomes Improve Over Long-term Due to Quality Improvement Collaborative
- Published on Thursday, 09 August 2012 17:21
Extensive retrospective study shows increased survival, reduced infections and potentially better respiratory practices among very low birth weight infants at hospitals in the collaborative
MINNEAPOLIS/ST. PAUL, March 1, 2010 —New research published in the March issue of Pediatrics shows that long-term quality improvement efforts are associated with sustained improvement in outcome and survival for very low birth weight infants, or “micro preemies,” treated in neonatal intensive care units (NICU) in a quality improvement collaborative (QIC). The study defined low birth weight infants as those who weigh between 501 and 1,500 grams (less than 3 pounds, 5 ounces).
The retrospective study of more than 4,000 very low birth weight infants showed that participation in the QIC was associated with sustained implementation of potentially better respiratory practices, increased survival and reduced hospital-acquired infections. Researchers analyzed nine years of data related to practices and outcomes from the eight NICUs that form the Reduced Lung Injury group of a QIC sponsored by the Vermont Oxford Network.
“This study shows that QICs really can improve outcomes, even though it may take not weeks or months but years,” said the study’s lead author, Nathaniel R. Payne M.D., a neonatologist at Children’s Hospitals and Clinics of Minnesota, one of the eight hospitals in the QIC.
“In addition, we saw enduring changes in the treatment practices, another key goal of QICs,” added Payne.
Research into better treatment practices for micro preemies is important due to the fact that, although significant strides have been made in the treatment of these low birth weight babies, these patients continue to face significant obstacles to their survival and quality of life.
Among the significant changes in practices that were developed and adopted early among the collaborative from 1998 to 2006 were reductions in the use of mechanical ventilation (from 75 percent to 62 percent), delivery room intubation (from 70 percent to 52 percent), postnatal steroids (from 35 percent to 10 percent) and increase in the early administration of surfactants (from 55 percent to 81 percent) and nasal continuous positive airway pressure (from 57 percent to 78 percent). The study found that these potentially better practices were significant and sustained, infection rates were reduced (from 18 percent to 15 percent) and survival rates improved (from 90 percent to 93 percent).
“The bottom line is that quite a few babies survived that might not have otherwise, and the reduction in infection rates meant fewer deaths, shorter hospital stays and lower costs,” Dr. Payne said.
The study did not find, however, that these practices lead to a reduction in the rate of a chronic lung disorder among micro preemies called bronchopulmonary dysplasia (BPD), which involves inflammation and scarring in the lungs. BPD, which increased from 25 percent to 29 percent, has been associated with prolonged use of mechanical ventilation.
“Reducing BPD rates may be more complicated than merely reducing mechanical ventilation,” said Dr. Payne. “These results will help guide our future quality improvement initiatives to reduce BPD.”
Since postnatal steroids are known to impede growth and neurological development, one of the goals of the QIC was to reduce their use. However, these steroids can reduce BPD, so limiting their use may have contributed to the increase in BPD, according to Dr. Payne.
The study’s findings support the value of long-term quality improvement efforts to understand the condition of patients and the complex interactions of therapies used to treat them.
“This sort of collaborative – my hospital, Children’s of Minnesota participates in a number of them – is essential to accelerate improvement in pediatric care,” said Dr. Payne.
About Children's Hospitals and Clinics of Minnesota
Serving as Minnesota's children's hospital since 1924, Children's Hospitals and Clinics of Minnesota is the seventh-largest pediatric health care organization in the United States, with 332 staffed beds at its two hospitals in St. Paul and Minneapolis. An independent, not-for-profit health care system, Children's of Minnesota provides care through more than 14,000 inpatient visits and more than 200,000 emergency room and other outpatient visits every year. Children's is the only Minnesota hospital system to provide comprehensive care exclusively to children.
Children’s Hospitals and Clinics Launch Direct Access Interpreter Phone Lines for Non-English Speaking Callers
- Published on Thursday, 09 August 2012 17:11
MINNEAPOLIS/ST. PAUL (March 1, 2010) – Families who are not proficient in English have a new user-friendly resource to help them with their child’s health care needs. Beginning March 1, Children’s Hospitals and Clinics of Minnesota is offering dedicated interpreter phone lines that give Hispanic and Somali callers immediate access to trained health care interpreters who can connect them with any department or clinic at Children’s.
Interpreters have always been available at Children’s, but callers had to call a main line first where they would most likely reach someone who does not speak their language. The family had to communicate the need for an interpreter and would be placed on hold while an interpreter was called. Sometimes calls would be lost or the families would hang up.
“Language can be a significant barrier for some families who are trying to access the health care system,” said Boris Kalanj, director of the Office for Health Care Equity at Children’s. “As hard as we have worked to make interpreters available, that initial point of contact can leave families feeling frustrated or confused. With this new phone line we wanted to enhance access to our health care system by giving families a chance to connect with an interpreter before connecting with anyone else at Children’s, who may not speak their language.”
The new service will initially cover Spanish and Somali families, which account for about 90% of the interpreter services volume at Children’s. The phone lines will be serviced by a combination of Children’s staff interpreters and contracted interpreters from an outside agency.
Under the new system, families simply dial a local phone number dedicated for their language. The numbers are: (612) 813-7500 (Spanish) and (612) 813-2020 (Somali).
An interpreter will answer the call in the designated language, identify the caller’s needs, and connect them to the appropriate person, department, clinic or unit for help. The interpreter will remain on the line throughout the call, providing interpretation and connection assistance until all of the caller’s needs have been addressed. The new interpreter lines are being funded in part by grants from three foundations: the Robins, Kaplan, Miller & Ciresi L.L.P. Private Foundation, the Michael V. and Ann C. Ciresi Charitable Foundation, and the Robins, Kaplan, Miller & Ciresi Foundation for Children. The program is part of an ongoing effort by Children’s to address health care disparities in Minnesota.
About Children's Hospitals and Clinics of Minnesota
Serving as Minnesota's children's hospital since 1924, Children's Hospitals and Clinics of Minnesota has 332 staffed beds at its two hospitals in St. Paul and Minneapolis. An independent, not-for-profit health care system, Children's of Minnesota provides care through more than 14,000 inpatient visits and more than 200,000 emergency room and other outpatient visits every year. Children's is the only Minnesota hospital system to provide comprehensive care exclusively to children.
Children’s Hospitals and Clinics of Minnesota Calls on Local Artists for New Arts and Healing Initiative
- Published on Thursday, 09 August 2012 17:27
Partnership with Minnesota Arts Organizations and Artists Aimed at Creating a Healing Environment at Minneapolis and St. Paul Hospitals
MINNEAPOLIS/ST. PAUL (January 14, 2010) – Children’s Hospitals and Clinics of Minnesota is launching a major new initiative aimed at bringing work by local artists into the Minneapolis and St. Paul Hospitals. This Arts and Healing initiative will feature partnerships with local arts organizations, and will work to foster a healing environment for patients and families at Children’s. The program will also study the impact arts programs can have on patient care.
A “Call for Art” has been released and is open to all Minnesota artists. Details of the program are available on www.ChildrensMN.org. Artists interested in learning more can also attend an Arts Forum on January 14, from 6 to 7:30 pm in the Pillsbury Auditorium at the Minneapolis Institute of Arts, 2400 Third Avenue South, Minneapolis, MN. Children’s executives and members of Children’s Arts & Healing and Urban Renewal Task Force will be on hand to answer questions about the program and the opportunities for local artists.
Children’s Arts and Healing Program will be brought to the community in partnership with The Children’s Theatre Company, COMPAS (an artist-in-residency and arts education organization based in St. Paul), MacPhail Center for Music, the Minnesota Children’s Museum and the Minneapolis Institute of Arts. The program will be funded entirely through philanthropic donations and will include exhibits of two- and three-dimensional art, interactive art programs for patients, and evidence-based research about the role of art in helping patients heal. Children’s is already a leader in bringing arts programs to patients such as music therapy.
Phase one of the project in Minneapolis is scheduled to be complete in September of 2010 and will include more than 30 major commissions along with acquisition of hundreds of works of art. This program is planned to be expanded system wide with the inclusion of the St. Paul Campus, scheduled for completion of fall 2011.
Attendees to the forum will have the opportunity to hear more about the project from Alan L. Goldbloom, MD, president and CEO of Children’s; Mic Johnson, senior partner with Ellerbe Becket; Mary Ingebrand-Pohlad, an artist, a long-standing trustee of the Minneapolis Institute of Arts, and a member of Children’s Arts & Healing and Urban Renewal Task Force; and Annette Ridenour, president of Aesthetics, an art consultant for the project. Ridenour has recently co-authored a book, “Transforming the Healthcare Experience through the Arts,” and will be giving a brief overview on the field as background information about evidence based arts programs.
Members of the five arts partners also will be present to discuss the collaboration.
The Arts and Healing initiative is part of Children’s multi-year $300 million redevelopment, which was launched in 2007 on both the Minneapolis and St. Paul campuses. Children’s has already opened several new facilities in Minneapolis, including a new Neonatal Intensive Care Unit, a five-story Children’s Specialty Center and a state-of-the-art Emergency Department.
About Children’s Hospitals and Clinics of Minnesota
Serving as Minnesota’s children’s hospital since 1924, Children’s Hospitals and Clinics of Minnesota has 332 staffed beds at its two hospitals in St. Paul and Minneapolis. An independent, not-for-profit health care system, Children’s of Minnesota provides care through more than 14,000 inpatient visits and more than 200,000 emergency room and other outpatient visits every year. Children’s is the only Minnesota hospital system to provide comprehensive care exclusively to children. For more information, visit www.childrensmn.org.