Established Evidence Results

Results for Keyword:

Below are articles that support specific interventions to advance MCH National Performance Measures (NPMs) and Standardized Measures (SMs). Most interventions contain multiple components as part of a coordinated strategy/approach.

Displaying records 1 through 2 (2 total).

Carlton, K., Adams, S., Fischer, E., Foy, A., Heffelfinger, A., Jozwik, J., Kim, I., Koop, J., Miller, L., Stibb, S., & Cohen, S. (2023). HOPE and DREAM: A Two-Clinic NICU Follow-up Model. American journal of perinatology, 10.1055/a-2053-7513. Advance online publication. https://doi.org/10.1055/a-2053-7513

Evidence Rating: Emerging

Intervention Components (click on component to see a list of all articles that use that intervention): Development/Improvement of Services, Needs Assessment, Consultation Systems (Hospital), HOSPITAL, Reorganization of Neonatal Services, NATIONAL

Intervention Description: The natural extension of inpatient-focused neonatal neurocritical care (NNCC) programs is the evaluation of long-term neurodevelopmental outcomes in the same patient population.

Intervention Results: To achieve this goal, we devised a two-clinic follow-up model at Children's Wisconsin: HOPE (Healthy Outcomes Post-ICU Engagement) and DREAM: Developmentally Ready: Engagement for Achievement of Milestones) clinics. Those infants with significant neurologic diagnoses attend DREAM clinic, while all other high-risk neonatal intensive care unit (NICU) infants are seen in the HOPE clinic.

Conclusion: These clinic models allow for a targeted approach to post-NICU care, which has improved family engagement and perceptions of value.

Access Abstract

Gale C, Santhakumaran S, Nagarajan S, Statnikov Y, Modi N. Impact of managed clinical networks on NHS specialist neonatal services in England: population based study. BMJ. 2012;344:e2105.

Evidence Rating: Emerging Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): Reorganization of Neonatal Services, NATIONAL, POPULATION-BASED SYSTEMS

Intervention Description: To assess the impact of reorganisation of neonatal specialist care services in England after a UK Department of Health report in 2003.

Intervention Results: After reorganisation, there were increases in the proportions of babies born at 27-28 weeks' gestation in hospitals providing the highest volume of neonatal specialist care (18% (631/3495) v 49% (1325/2724); odds ratio 4.30, 95% confidence interval 3.83 to 4.82; P<0.001) and in acute and late postnatal transfers (7% (235) v 12% (360) and 18% (579) v 22% (640), respectively; P<0.001). There was no significant change in the proportion of babies from multiple births separated by transfer (33% (39) v 29% (38); 0.86, 0.50 to 1.46; P=0.57). In epoch two, 32% of acute transfers were to a neonatal unit providing either an equivalent (n=87) or lower (n=26) level of specialist care.

Conclusion: There is evidence of some improvement in the delivery of neonatal specialist care after reorganisation.

Study Design: QE: pretest-posttest

Setting: Pretest: 294 maternity centers and neonatal units in England, Wales and Northern Ireland Posttest: 146 neonatal units (23 managed clinical networks) in England

Population of Focus: Infants born at 27+0 to 28+6 (weeks+ days) GA In pretest, live births In posttest, admitted to a neonatal unit (no details on babies who died in labor ward)

Data Source: Pretest: Data from a published report of the Confidential Enquiry into Stillbirths and Deaths in Infancy Project 27/28 which identified 28 day outcomes of all live births at 27-28 weeks GA in England, Wales, and Northern Ireland. Posttest: Data from National Neonatal Research Database held by the Neonatal Data Analysis Unit.

Sample Size: Pretest (n=3,522) Posttest (n=2,919)

Age Range: Not specified

Access Abstract