Journal
CANADIAN MEDICAL ASSOCIATION JOURNAL
Volume 181, Issue 8, Pages 469-476Publisher
CMA-CANADIAN MEDICAL ASSOC
DOI: 10.1503/cmaj.081727
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Funding
- Canadian Institutes of Health Research [MOP-53115]
- BC's Children's Hospital Foundation
- Calgary Regional Health Authority
- Dalhousie University Neonatal-Perinatal Research Fund
- Division of Neonatology, Children's Hospital of Eastern Ontario
- Child Health Program
- Health Care Corporation of St John's
- Janeway Hospital Foundation
- Newfoundland and Labrador Centre for Applied Health Research
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Background: We developed and tested a new method, called the Evidence-based Practice for Improving Quality method, for continuous quality improvement. Methods: We used cluster randomization to assign 6 neonatal intensive care units (ICUs) to reduce nosocomial infection (infection group) and 6 ICUs to reduce bronchopulmonary dysplasia (pulmonary group). We included all infants born at 32 or fewer weeks gestation. We collected baseline data for 1 year. Practice change interventions were implemented using rapid-change cycles for 2 years. Results: The difference in incidence trends (slopes of trend lines) between the ICUs in the infection and pulmonary groups was -0.0020 (95% confidence interval [CI]-0.0007 to 0.0004) for nosocomial infection and -0.0006 (95% CI -0.0011 to -0.0001) for bronchopulmonary dysplasia. Interpretation: The results suggest that the Evidence-based Practice for Improving Quality method reduced bronchopulmonary dysplasia in the neonatal ICU and that it may reduce nosocomial infection.
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