DOI QR코드

DOI QR Code

Quality Improvement in Neonatal Intensive Care Units

  • Kim, Eun Sun (Department of Pediatrics, Kangwon National University School of Medicine)
  • Received : 2018.05.09
  • Accepted : 2018.05.23
  • Published : 2018.05.31

Abstract

Even with the increasing number of high risk infants, neonatal care in Korea has undergone development with improved survival rate. This rapid improvement in the outcomes brought care quality in neonatal intensive care unit (NICU) to the surface. Quality improvement (QI) involves safe, timely, effective, efficient, equitable, and patient-centered care. In this review, methods of QI are described with examples of NICU QI topics. Each NICU can voluntarily develop a QI project, but systematic supports are essential. As human and systemic resources in NICUs in Korea are insufficient, institutional and national supports are necessary to attain QI. Furthermore, collaborative neonatal network can provide a QI standard and evidence based-medicine, as well as QI research.

Keywords

References

  1. Korean Statistical Information Service. Birth statistics [Internet]. Daejeon: KOSIS; 2018 [cited 2018 May 21]. Available from: http://www.kosis.kr.
  2. Chang YS, Park HY, Park WS. The Korean Neonatal Network: an overview. J Korean Med Sci 2015;30 Suppl 1:S3-11. https://doi.org/10.3346/jkms.2015.30.S1.S3
  3. Batalden PB, Davidoff F. What is "quality improvement" and how can it transform healthcare? Qual Saf Health Care 2007; 16:2-3.
  4. Institution of Medicine US, Committee on Quality of Health Care in America. Crossing the quality chasm: a new health system for the 21st century. Washington, DC: National Academy Press, 2001.
  5. McGlynn EA, Asch SM, Adams J, Keesey J, Hicks J, DeCristofaro A, et al. The quality of health care delivered to adults in the United States. N Engl J Med 2003;348:2635-45. https://doi.org/10.1056/NEJMsa022615
  6. Mangione-Smith R, DeCristofaro AH, Setodji CM, Keesey J, Klein DJ, Adams JL, et al. The quality of ambulatory care delivered to children in the United States. N Engl J Med 2007;357: 1515-23. https://doi.org/10.1056/NEJMsa064637
  7. Kohn LT, Corrigan J, Donaldson MS. To err is human: building a safer health system. Washington, DC: National Academy Press, 2000.
  8. Langley G, Moen R, Nolan K, Nolan T, Norman C, Provost L. The improvement guide: a practical approach to enhancing organizational performance. 2nd ed. San Francisco: Jossey-Bass Press, 2009.
  9. Donabedian A. Explorations in quality assessment and monitoring. The definition of quality and approaches to its assessment. Vol. 1. Ann Arbor: Health Administration Press, 1980.
  10. Institution for Healthcare Improvement. Open school [Internet]. Boston: Institution for Healthcare Improvement; c2018 [cited 2018 May 21]. Available from: http://www.ihi.org/education/ihiopenschool.
  11. Provost LP, Murray S. The health care data guide: learning from data for improvement. San Francisco: Jossey-Bass Press, 2011.
  12. Chawla D, Suresh GK. Quality improvement in neonatal care: a new paradigm for developing countries. Indian J Pediatr 2014; 81:1367-72. https://doi.org/10.1007/s12098-014-1406-7
  13. Balakrishnan M, Raghavan A, Suresh GK. Eliminating undesirable variation in neonatal practice: balancing standardization and customization. Clin Perinatol 2017;44:529-40. https://doi.org/10.1016/j.clp.2017.04.002
  14. American Academy of Pediatrics Steering Committee on Quality Improvement and Management. Classifying recommendations for clinical practice guidelines. Pediatrics 2004; 114:874-7. https://doi.org/10.1542/peds.2004-1260
  15. Isaac A, Saginur M, Hartling L, Robinson JL. Quality of reporting and evidence in American Academy of Pediatrics guidelines. Pediatrics 2013;131:732-8. https://doi.org/10.1542/peds.2012-2027
  16. Berwick DM. Era 3 for medicine and health care. JAMA 2016; 315:1329-30. https://doi.org/10.1001/jama.2016.1509
  17. Ehret DY, Patterson JK, Bose CL. Improving neonatal care: a global perspective. Clin Perinatol 2017;44:567-82. https://doi.org/10.1016/j.clp.2017.05.002

Cited by

  1. Restriction of Central Line Insertion and Prophylactic Antibiotics Usage in Moderate and Late Preterm Infants from a Quality Improvement Perspective vol.30, pp.2, 2018, https://doi.org/10.14734/pn.2019.30.2.71
  2. Survival and Cause of Death among Extremely Preterm Infants Near the Limit of Viability vol.31, pp.2, 2018, https://doi.org/10.14734/pn.2020.31.2.61
  3. Educational needs for practicing neonatal intensive care among Korean nursing students vol.27, pp.4, 2018, https://doi.org/10.4094/chnr.2021.27.4.339