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  • Quality Improvement Article
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Quality Improvement

Promoting teamwork may improve infant care processes during delivery room management: Florida perinatal quality collaborative’s approach

Journal of Perinatology volume 37, pages 886–892 (2017)Cite this article

Subjects

Abstract

Background:

LOCAL PROBLEM: Inadequate understanding of compliance with standardized evidence-based DR management. INTERVENTIONS: Promote inter-professional teamwork and a bundle of interventions focusing on resuscitation team roles, equipment check, and debriefing using QI methodology. Optimize delivery room (DR) management to achieve 10-min SPO2 targets, delayed-cord clamping (DCC), team role assignment and debriefings in >50% of deliveries, and achieve normothermia in >75% of infants.

Methods:

Over 15 months (Epoch 1 to 5), nine Florida hospitals implemented a DR management plan for infants <31 weeks gestational age or <1500 g (N=814) using quality improvement methodology.

Results:

There was increased compliance of DCC (36 to 66%), role assignment (53 to 98%), debriefing rates (33 to 76%) and having all seven pre-delivery preparedness components fulfilled (34 to 75%). There were no significant improvements in admission temperatures or SPO2 targeting. When 7 vs 0 items of pre-delivery preparedness were completed, we saw improvements in thermoregulation (57% vs 72%), SPO2 targeting (60% vs 78%) and DCC compliance (43 to 67%).

Conclusion:

Promoting teamwork by increasing pre-delivery preparedness is associated with improvement of thermoregulation, SPO2 targeting and DCC compliance.

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Acknowledgements

We greatly appreciate Dr Jane Carver’s editorial review of the manuscript. The FPQC would like to thank each of the following hospitals and their teams for participation and contributions to this initiative: Johns Hopkins All Children’s Hospital, St Petersburg; Baptist Hospital of Miami, Miami; Broward Health Medical Center, Fort Lauderdale; Florida Hospital Tampa, Tampa; Plantation General Hospital, Plantation; Sarasota Memorial Hospital, Sarasota; South Miami Hospital, South Miami; St Joseph’s Hospital, Tampa; and Tampa General Hospital, Tampa. Health Management Associates who provide subcontracts via a federal grant to Florida’s Agency for Health Care Administration from the Centers for Medicare and Medicaid (USF Budget Code: 6405105701).

Author information

Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, University of South Florida Health, Tampa, FL, USA

    M Balakrishnan, J S Curran & T L Ashmeade

  2. Department of Community and Family Health, Lawton and Rhea Chiles Center for Healthy Mothers and Babies, College of Public Health,

    N Falk-Smith, L A Detman & W M Sappenfield

  3. University of South Florida Health, Tampa, FL, USA

    N Falk-Smith, L A Detman & W M Sappenfield

  4. Center for Comparative Effectiveness Research,

    B Miladinovic

  5. Division of Evidence-Based Medicine, Department of Internal Medicine, University of South Florida Health, Tampa, FL, USA

    B Miladinovic

Authors
  1. M Balakrishnan
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  2. N Falk-Smith
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  3. L A Detman
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  4. B Miladinovic
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  5. W M Sappenfield
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  6. J S Curran
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  7. T L Ashmeade
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Corresponding author

Correspondence to M Balakrishnan.

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The authors declare no conflict of interest.

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Balakrishnan, M., Falk-Smith, N., Detman, L. et al. Promoting teamwork may improve infant care processes during delivery room management: Florida perinatal quality collaborative’s approach. J Perinatol 37, 886–892 (2017). https://doi.org/10.1038/jp.2017.27

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  • DOI: https://doi.org/10.1038/jp.2017.27

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