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Estimating the quality of neonatal transport in California

Journal of Perinatology volume 33, pages 964–970 (2013)Cite this article

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Abstract

Objective:

To develop a strategy to assess the quality of neonatal transport based on change in neonatal condition during transport.

Study Design:

The Canadian Transport Risk Index of Physiologic Stability (TRIPS) score was optimized for a California (Ca) population using data collected on 21 279 acute neonatal transports, 2007 to 2009, using models predicting (2/3) and validating (1/3) mortality within 7 days of transport. Quality Change Point 10th percentile (QCP10), a benchmark of the greatest deterioration seen in 10% of the transports by top-performing teams, was established.

Result:

Compared with perinatal variables (0.79), the Ca-TRIPS had a validation receiver operator characteristic area for prediction of death of 0.88 in all infants and 0.86 in infants transported after day 7. The risk of death increased 2.4-fold in infants whose deterioration exceeded the QCP10.

Conclusion:

We present a practical, benchmarked, risk-adjusted, estimate of the quality of neonatal transport.

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Acknowledgements

CPeTS data: This work was supported by California Department of Health, Maternal Child and Adolescent Health Branch.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Division of Neonatal–Perinatal Medicine Stanford University School of Medicine, Stanford, CA, USA

    J B Gould & B Murphy

  2. California Perinatal Quality Care Collaborative, Palo Alto, CA, USA

    J B Gould & B Murphy

  3. Health InfomationSolutions, Rocklin, CA, USA

    B H Danielsen

  4. California Family Health Council, Los Angeles, CA, USA

    L Bollman

  5. California Perinatal Transport System, Sacramento, CA, USA

    L Bollman, A Hackel & B Murphy

  6. Department of Pediatrics and Anesthesiology, Stanford University School of Medicine, Stanford, CA, USA

    A Hackel

Authors
  1. J B Gould
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  2. B H Danielsen
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  3. L Bollman
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  4. A Hackel
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  5. B Murphy
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Corresponding author

Correspondence to J B Gould.

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The authors declare no conflict of interest.

Appendices

Appendix Table A1

Table 4 Comparison of original TRIPS, recalibrated California TRIPS and modified California TRIPS
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Appendix Table A2

Table 5 Final California Model used for calculating California-TRIPS
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Appendix Table A3

Table 6 Example for use of QCP in CPQCC reporting back to members, mean change in TRIPS from initial evaluation to NICU admission, by birth weight (g)
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Appendix Table A4

Table 7 CORE CPeTS Acute Inter-facility—Neonatal Transport Form
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Gould, J., Danielsen, B., Bollman, L. et al. Estimating the quality of neonatal transport in California. J Perinatol 33, 964–970 (2013). https://doi.org/10.1038/jp.2013.57

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