A systematic review of reports of quality improvement for bronchopulmonary dysplasia

Area of Science:

• Neonatal Medicine
• Pediatric Respiratory Medicine
• Healthcare Quality Improvement

Background:

• Bronchopulmonary dysplasia (BPD) remains the most common morbidity in preterm infants.
• Current research and interventions have not significantly reduced BPD incidence compared to other prematurity-related morbidities.
• Variability in BPD rates across institutions suggests potential for quality improvement (QI).

Purpose of the Study:

• To systematically review quality improvement (QI) efforts aimed at reducing BPD in preterm infants.
• To identify effective QI strategies and lessons learned from past interventions.
• To inform future research and QI initiatives for BPD management.

Main Methods:

• Systematic review of published reports on QI for BPD in preterm infants.
• Analysis of 22 single-center reports and 7 collaborative efforts over the past two decades.
• Evaluation of respiratory QI interventions and their impact on BPD rates and other respiratory outcomes.

Main Results:

• Respiratory QI interventions were successful in reducing BPD or other key respiratory measures in nearly all reviewed reports.
• Effectiveness was particularly noted in infants with a birth weight exceeding 1000 grams.
• Identified common themes and lessons from successful QI initiatives.

Conclusions:

• Quality improvement initiatives demonstrate significant potential for reducing BPD in preterm infants.
• QI interventions are a viable strategy to address the persistent challenge of BPD.
• Lessons learned can guide future research and implementation of QI to decrease the burden of BPD.