Improving Care for Neonatal Abstinence Syndrome

Area of Science:

• Neonatal care
• Quality improvement science
• Pharmacotherapy outcomes

Background:

• Neonatal abstinence syndrome (NAS) care varies significantly across hospitals.
• Standardized protocols are needed to improve outcomes for infants with NAS.

Purpose of the Study:

• To assess the effectiveness of a multicenter quality improvement collaborative in standardizing care for infants with NAS.
• To determine if the collaborative improved patient outcomes, including treatment duration and length of stay.

Main Methods:

• A multicenter quality improvement collaborative was implemented from 2012 to 2014.
• Data on hospital policies and patient outcomes (pharmacotherapy duration, length of stay) were collected via serial audits.
• Statistical models evaluated changes in patient outcomes over time.

Main Results:

• Participating centers increased NAS-focused guidelines from 3.7 to 5.1 (P < .001).
• Median length of pharmacologic treatment decreased from 16 to 15 days (P = .02).
• Median length of hospital stay (LOS) decreased from 21 to 19 days (P = .002), with a standardized scoring process associated with a 3.3-day shorter LOS.

Conclusions:

• Multicenter collaboration effectively standardized hospital patient care policies for infants with NAS.
• Involvement in the collaborative led to decreased healthcare utilization for NAS patients.
• Quality improvement initiatives can improve care consistency and reduce resource use in neonatal abstinence syndrome management.