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Quality Improvement Learning Collaborative Improves Timely Newborn Follow-Up Appointments
Insights
A nine-month quality improvement learning collaborative (QILC) successfully improved timely newborn follow-up appointments. Pediatric practices achieved sustained progress in scheduling and seeing newborns within three days of discharge.
Area of Science:
- Pediatrics
- Quality Improvement
- Healthcare Management
Background:
- American Academy of Pediatrics recommends newborn follow-up within three days of discharge.
- Barriers to timely newborn follow-up can negatively impact infant health.
- This project aimed to address these barriers and improve adherence to guidelines.
Purpose of the Study:
- To improve rates of timely newborn follow-up appointments.
- To implement and evaluate a nine-month quality improvement learning collaborative (QILC).
- To define timely newborn follow-up as an appointment scheduled within three days of discharge.
Main Methods:
- A nine-month quality improvement learning collaborative (QILC) involving inpatient and outpatient pediatric practices.
- Practices set goals for scheduling (75%) and seeing (60%) newborns within three days of discharge.
- Monthly webinars facilitated didactic sessions, data review, and sharing of strategies.
Main Results:
- Eleven practices and 24 physicians participated.
- Aggregate data showed continuous improvement in newborn scheduling metrics throughout the QILC.
- Progress was sustained in the final three months of the collaborative.
Conclusions:
- Quality improvement learning collaboratives are effective for enhancing timely newborn follow-up.
- Pediatric providers can benefit from shared strategies and successes to improve practice.
- The QILC model supports both inpatient hospitalists and outpatient pediatricians in optimizing newborn care transitions.
Background:
American Academy of Pediatrics guidelines indicate that newborns should follow up with their primary care providers within three days of discharge from the newborn nursery. Many barriers exist to achieving timely follow-up, with potential implications on a newborn's health. The goal of this project was to improve rates of timely newborn follow-up through a nine-month quality improvement learning collaborative (QILC). Timely newborn follow-up was defined as an appointment scheduled within three days of newborn discharge.
Methods:
Both inpatient hospitalist and outpatient pediatric practices were eligible to participate. Inpatient and outpatient practices aimed to have 75% of newborns scheduled appropriately by six months into the project. In addition, outpatient practices aimed to have 60% of newborns seen appropriately by their provider. All practices aimed to have their progress sustained at conclusion of the QILC. Practices submitted data at baseline and nine subsequent phases. Monthly webinars featured a quality improvement didactic, data review, and discussion of practices' changes, successes, and challenges.
Results:
Eleven practices and 24 physicians participated in the QILC. Aggregate data from the practices showed continual improvement in all measured newborn scheduling metrics throughout the nine-month learning collaborative, with sustainment of progress over the last three months of the QILC.
Conclusion:
A QILC is successful for increasing timely newborn follow-up for both the newborn hospitalist and outpatient pediatrician. Pediatric providers can learn from others' strategies and successes to incorporate meaningful changes in their practice.
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