Improving Delayed Cord Clamping Across Tennessee Through a Statewide Quality Collaborative

Area of Science:

• Neonatal care
• Perinatal quality improvement
• Public health initiatives

Background:

• Delayed cord clamping (DCC) offers significant benefits to newborns.
• Standardizing DCC practices is crucial for improving infant outcomes.
• A quality improvement (QI) initiative aimed to increase DCC rates.

Purpose of the Study:

• To increase the proportion of infants receiving delayed cord clamping (DCC) for at least 60 seconds to a minimum of 90% in participating hospitals.
• To implement and evaluate a statewide QI initiative for DCC.
• To monitor the impact of DCC on infant care.

Main Methods:

• A QI initiative was launched in 5 pilot hospitals in January 2022, expanding to 22 more in May 2022.
• Monthly data collection tracked live births, DCC rates, and infant demographics from January 2022 to June 2023.
• Balancing measures (Apgar scores, hypothermia) and process measures were monitored.

Main Results:

• 83% (61,642/74,241) of infants received DCC for at least 60 seconds.
• The aggregate baseline DCC rate of 76% improved to an adjusted mean rate of 87% after the intervention.
• The positive impact of the QI initiative was observed consistently across all facility levels.

Conclusions:

• The statewide perinatal QI collaborative successfully enhanced the implementation of DCC practices.
• Evidence-based QI initiatives are effective in increasing the uptake of recommended infant care practices.
• This initiative demonstrates a significant improvement in infant care during birth through standardized DCC.