Neonatal Services

Safe 

Interpretation: Very low birth weight newborns in the Minneapolis and St. Paul Neonatal Intensive Care Units (NICU) have a combined rate of hospital acquired infections much lower than the VON average. Our ultimate goal is to have zero infections. The St. Paul campus has had no infections related to a central venous catheter so far in 2010.

What are we doing to improve:Quality improvement teams on each campus have worked for many years to reduce infections.

Data source: The Vermont Oxford Network (VON) is a consortium of over 800 NICU's from all over the world. NICU's submit their data to the VON and receive annual reports of their performance compared to all other NICU's.

Benchmark data: The Vermont Oxford Network.

Interpretation: Intraventricular hemorrhage (IVH, bleeding within the brain) is a risk of being an extremely very low birth weight infant. The most severe grades of IVH (Grades 3-4 IVH) can cause lifelong handicap. This chart shows our results compared to all other Neonatal Intensive Care Units (NICU) in the Vermont Oxford Network after adjustment for how sick the patients were at admission. Our rates for IVH improved in 2009.

What are we doing to improve: Improving survival without increasing complications, such as intracranial bleeding, has been and is one of our most important goals.

Data source: The Vermont Oxford Network (VON) is a consortium of over 800 NICU's from all over the world. NICU's submit their data to the VON and receive annual reports of their performance compared to all other NICU's.

 Benchmark data: The Vermont Oxford Network.

Interpretation: Retinopathy of prematurity (ROP) is abnormal development of the back of the eye (retina) that can cause lifelong vision loss. Very low birth weight infants are at greatest risk. Neonatal Intensive Care Unit (NICU) staff can influence (but not altogether prevent) the development of ROP. Both NICU's have worked to reduce severe ROP. We made particularly good progress in 2009.

What are we doing to improve: Improving survival without increasing complications, such as ROP, is one of our primary goals.

Data source: The Vermont Oxford Network (VON) is a consortium of over 800 NICU's from all over the world. NICU's submit their data to the VON and receive annual reports of their performance compared to all other NICU's.

Benchmark Data: The Vermont Oxford Network.

Timely 

This measure is still in process.

Efficient 

Interpretation: The length of stay (days) is how long a patient stays in the hospital. Children's length of stay is similar to its peers.

What are we doing to improve: Improved discharge planning is the focus of an ongoing quality improvement project.

Data source: The Vermont Oxford Network (VON) is a consortium of more than 800 Neonatal Intensive Care Units (NICU) from all over the world. NICUs submit their data to the VON and receive annual reports of their performance compared to all other NICUs.

Benchmark data: The Vermont Oxford Network.

Effective 

Interpretation: Very low birth weight newborns in the Minneapolis and St. Paul Neonatal Intensive Care Units (NICU) have a combined survival rate that is comparable to the average from the Vermont Oxford Network. Survival increased in 2009, reflecting our continuing efforts at quality improvement. Adjusting for risk factors at admission showed that both campuses had survival that was better than expected based on how sick our patients were at admission to the NICU. In 2009, there were 23 more survivors than expected in Minneapolis and 15 in St. Paul.

What are we doing to improve: Improved survival reflects improvements in delivery room management and better management of lung problems.

Data source: The Vermont Oxford Network (VON) is a consortium of over 800 NICU's from all over the world. NICU's submit their data to the VON and receive annual reports of their performance compared to all other NICU's.

Benchmark data: The Vermont Oxford Network.

Interpretation: Extracorporeal membrane oxygenation (ECMO) is a highly complex treatment used for children who are severely ill. The ECMO machine temporarily acts as a patient's heart and lungs while he or she recovers from an underlying condition.

We have better outcomes for all neonatal patients when compared to the international Extracorporeal Life Support Organization (ELSO) registry. Two of the most difficult groups to treat with ECMO are patients with congenital heart defects and congenital diaphragmatic hernia. Children's has exceptional outcomes for these patients compared to other ECMO centers.

What are we doing to improve: Children's ECMO program continues to refine our institutional protocols based on our patient outcomes compared to national outcomes. We also participate in multicenter research efforts aimed at improving patient outcomes.

Data source: Extracorporeal Life Support Organization (ELSO) is an international comprehensive registry of patients treated with ECMO.

Benchmark data: 115 international ECMO centers

Patient-family centered 

Care and Compassion

Interpretation: Most families said that staff definitely showed genuine care and compassion for them and their child. Fourteen percent of families said that staff somewhat showed genuine care and compassion; only two percent families said staff did not show genuine care and compassion in the most recent time period. We are below our goal of 90%.

What are we doing to improve: We continuously train our staff on simple courtesies and other expressions of concern. We have also implemented family-centered rounds and family representatives for all units.

Data source: NRC Picker Family Survey

Benchmark data: Not available.

Willing to Recommend 

Interpretation: Most families would definitely recommend Children's to a friend or family member for care. Five percent of families said they would probably recommend Children's, less than 1% of families said they would notrecommend Children's in the most recent time period. We have exceeded our goal of 90%.

What are we doing to improve: We use feedback from our Family Advisory Council and family surveys to improve family experiences to help staff improve their interactions with patients and families.

Data source: NRC Picker Family Survey

Benchmark data: Not available.

Equitable 

Interpretation:The percent of very low birth weight newborns discharged alive or who are still in the hospital after one year is the same for White and Non-White infants.

What are we doing to improve: We monitor survival rates by race to ensure we provide the same care to all patients.

Data source: The Vermont Oxford Network (VON) is a consortium of over 800 Neonatal Intensive Care Units (NICU) from all over the world. NICU's submit their data to the VON and receive annual reports of their performance compared to all other NICU's.

Benchmark data: Not available.

Interpretation: When babies cannot survive due to birth defects, infections or other problems, it is not helpful to resuscitate them. However, we continuously monitor this metric to make sure that we do not overestimate the number of babies who should not be resuscitated. The percent of very low birth weight newborns resuscitated is the same for White and Non-White infants and there is no evidence of racial disparity in NICU care.

What are we doing to improve: We examine this and other measures of health care disparity regularly.

Data source: The Vermont Oxford Network (VON) is a consortium of more than 800 Neonatal Intensive Care Units (NICU) from all over the world. NICUs submit their data to the VON and receive annual reports of their performance compared to all other NICUs.

Benchmark Data: Not available.

neonatal 13 14

Children's of Minnesota has the largest high-risk neonatal referral center in the region. The combined bed capacity for the neonatal units on the Minneapolis and St. Paul campuses that are staffed and managed by Children's is 138 beds.

Neonatal care is a leading program at Children's, called a cornerstone program. These are major programs meeting rigorous criteria for excellence, including clinical research, use of advanced technology, and evidence-based practice. The program encompasses four inpatient units: the Minneapolis Neonatal Intensive Care Unit (NICU), the St. Paul NICU, the Minneapolis Infant Care Center (ICC) and the Special Care Nursery at Abbott Northwestern Hospital (SCN).

Both Neonatal Intensive Care Units (NICUs) are a part of the comprehensive high-and low-risk perinatal programs that are provided in conjunction with Abbott Northwestern Hospital in Minneapolis and United Hospital in St. Paul.

The neonatal service line is comprised of 20 neonatologists, 85 neonatal nurse practitioners, and more than 500 nurses and support staff. Children's neonatologists provide on-site coverage 24 hours a day, 7 days a week.


 Micro Preemies

people

Among the infants defined as very premature, Children's neonatal team delivers some of the highest survival and lowest complication rates in the world. Very premature infants, sometimes referred to as "micro preemies," are those who are born between 22 and 29 weeks gestation and frequently weigh less than 1,500 grams at birth.


Clinical Services

Premature infants have many special needs that increase the level of care required. The services and treatments offered increase the chance of survival while reducing the risks of serious long-term complications. Services offered at Children's include:


Families in the NICU:
View a 4-minute video of parents who have experienced Children's NICUs

blond

Play Video

Children's – Minneapolis:
View a 4-minute video to learn more about the unit and iservices for families.

twowomen

Play Video

Children's - St. Paul:
Take a 4-minute video tour of the private-room environment.

www

Play Video

Children's Hospitals and Clinics of Minnesota's Minneapolis Neonatal Intensive Care Unit Tour
A 7-minute video slide show of the NICU.

words

Play Video

peopleAmong the infants defined as very premature, Children's neonatal team delivers some of the highest survival and lowest complication rates in the world. Very premature infants, sometimes referred to as "micro preemies," are those who are born between 22 and 29 weeks gestation and frequently weigh less than 1,500 grams at birth.