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Measuring practice preference variation for quality improvement in neonatal respiratory care
Helen Healy1, Emily Whitesel2, Wenyang Mao2
1Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA. hhealy@bidmc.harvard.edu.
Summary
Neonatal intensive care units (NICUs) show varied preferences in respiratory care, especially for premature infants. Understanding these differences can improve quality improvement initiatives in neonatal respiratory support.
Area of Science:
- Neonatal Medicine
- Respiratory Care
- Healthcare Quality Improvement
Background:
- Practice variation in neonatal respiratory care can impact patient outcomes.
- Standardized tools are needed to assess and compare these variations across institutions.
Purpose of the Study:
- To measure and compare practice preference variations in neonatal respiratory care.
- To assess variations within and between neonatal intensive care units (NICUs).
- To utilize the Neonatology Survey of Interdisciplinary Groups in Healthcare Tool (NSIGHT) for this assessment.
Main Methods:
- Eleven NICUs participated in the NSIGHT survey between 2019 and 2021.
- Net preference was determined by mean response, and agreement by standard deviation.
- Heat maps were employed to visualize comparisons between NICUs and healthcare disciplines.
Main Results:
- High agreement was observed for pressure support with mandatory ventilation and non-invasive positive pressure ventilation for apnea.
- Significant preference variation existed regarding invasive ventilation versus CPAP for extremely low birth weight infants.
- Discrepancies in preferences were most common between neonatologists and nurses.
Conclusions:
- Practice preference variations in neonatal respiratory care are context-dependent.
- Quantifying these variations can inform change management strategies.
- Measuring preference variation is crucial for enhancing quality improvement efforts in NICUs.
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