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Research Articles

The Colorado Hospitals Substance Exposed Newborn Quality Improvement Collaborative: Standardization of Care for Opioid-Exposed Newborns Shortens Length of Stay and Reduces Number of Infants Requiring Opiate Therapy

Sunah S. Hwang, Blair Weikel, Jillian Adams, Stephanie L. Bourque, Jaime Cabrera, Nancy Griffith, Anne M. Hall, Jessica Scott, Danielle Smith, Colleen Wheeler, Jade Woodard and Erica Wymore
Hospital Pediatrics August 2020, hpeds.2020-0032; DOI: https://doi.org/10.1542/hpeds.2020-0032
Sunah S. Hwang
aDepartment of Pediatrics, School of Medicine, University of Colorado, Aurora, Colorado;
bSection of Neonatology, Children’s Hospital Colorado, Aurora, Colorado;
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Blair Weikel
aDepartment of Pediatrics, School of Medicine, University of Colorado, Aurora, Colorado;
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Jillian Adams
dIlluminate Colorado, Denver, Colorado; and
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Stephanie L. Bourque
aDepartment of Pediatrics, School of Medicine, University of Colorado, Aurora, Colorado;
bSection of Neonatology, Children’s Hospital Colorado, Aurora, Colorado;
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Jaime Cabrera
cColorado Perinatal Care Quality Collaborative, Denver, Colorado;
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Nancy Griffith
cColorado Perinatal Care Quality Collaborative, Denver, Colorado;
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Anne M. Hall
aDepartment of Pediatrics, School of Medicine, University of Colorado, Aurora, Colorado;
bSection of Neonatology, Children’s Hospital Colorado, Aurora, Colorado;
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Jessica Scott
aDepartment of Pediatrics, School of Medicine, University of Colorado, Aurora, Colorado;
bSection of Neonatology, Children’s Hospital Colorado, Aurora, Colorado;
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Danielle Smith
aDepartment of Pediatrics, School of Medicine, University of Colorado, Aurora, Colorado;
bSection of Neonatology, Children’s Hospital Colorado, Aurora, Colorado;
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Colleen Wheeler
eLutheran Medical Center, Wheat Ridge, Colorado
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Jade Woodard
dIlluminate Colorado, Denver, Colorado; and
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Erica Wymore
aDepartment of Pediatrics, School of Medicine, University of Colorado, Aurora, Colorado;
bSection of Neonatology, Children’s Hospital Colorado, Aurora, Colorado;
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Abstract

OBJECTIVES: To decrease the average length of stay (LOS) of opioid-exposed newborns (OENs) by 20% from baseline from April 2017 to December 2019.

METHODS: The Colorado Hospitals Substance Exposed Newborn Quality Improvement Collaborative is a consortium of neonatal providers, public health experts, and legislative experts that provides infrastructure and resources for Colorado birthing hospitals to undertake initiatives focused on improving the care of OENs. The Colorado Hospitals Substance Exposed Newborn Quality Improvement Collaborative was started in September 2017 and includes 19 birthing hospitals in Colorado, with 12 contributing data to the centralized database. The interventions were focused on (1) hospital engagement and (2) increasing nonpharmacologic care (by using the Eat, Sleep, Console assessment tool; developing guidelines for breastfeeding eligibility; employing comfort measures before pharmacologic therapy; and administering opiate therapy on an as-needed basis).

RESULTS: From April 2017 to December 2019, 787 OENs were identified. Among infants ≥35 weeks’ gestational age without other medical diagnoses (n = 647), statistical process control charts revealed significant reduction in the primary outcome of interest, average hospital LOS, from 14.8 to 5.9 days. For all OENs, receipt of pharmacologic therapy declined from 61% to 23%. Among OENs who received pharmacologic therapy (and were ≥35 weeks’ gestational age without other medical diagnoses), average LOS also declined from 21.9 to 8.0 days.

CONCLUSIONS: Through standardization of OEN care focused on family engagement and nonpharmacologic care, this statewide collaborative reduced average LOS, the percentage of OENs requiring opiate therapy, and average LOS for OENs requiring opiate therapy.

  • Copyright © 2020 by the American Academy of Pediatrics
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Hospital Pediatrics: 11 (3)
Hospital Pediatrics
Vol. 11, Issue 3
1 Mar 2021
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The Colorado Hospitals Substance Exposed Newborn Quality Improvement Collaborative: Standardization of Care for Opioid-Exposed Newborns Shortens Length of Stay and Reduces Number of Infants Requiring Opiate Therapy
Sunah S. Hwang, Blair Weikel, Jillian Adams, Stephanie L. Bourque, Jaime Cabrera, Nancy Griffith, Anne M. Hall, Jessica Scott, Danielle Smith, Colleen Wheeler, Jade Woodard, Erica Wymore
Hospital Pediatrics Aug 2020, hpeds.2020-0032; DOI: 10.1542/hpeds.2020-0032

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The Colorado Hospitals Substance Exposed Newborn Quality Improvement Collaborative: Standardization of Care for Opioid-Exposed Newborns Shortens Length of Stay and Reduces Number of Infants Requiring Opiate Therapy
Sunah S. Hwang, Blair Weikel, Jillian Adams, Stephanie L. Bourque, Jaime Cabrera, Nancy Griffith, Anne M. Hall, Jessica Scott, Danielle Smith, Colleen Wheeler, Jade Woodard, Erica Wymore
Hospital Pediatrics Aug 2020, hpeds.2020-0032; DOI: 10.1542/hpeds.2020-0032
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