Addressing drivers of healthcare utilization for neonatal opioid withdrawal syndrome. J Perinatol 2023 Mar;43(3):392-401
Date
10/07/2022Pubmed ID
36203084Pubmed Central ID
PMC9540302DOI
10.1038/s41372-022-01533-zScopus ID
2-s2.0-85139494271 (requires institutional sign-in at Scopus site) 1 CitationAbstract
OBJECTIVE: Aim to reduce healthcare utilization (HU) for infants at risk of neonatal opioid withdrawal syndrome (NOWS) by 30% in 1 year and sustain for 2 years.
STUDY DESIGN: Baseline data from three Level I & II newborn nurseries from January 2016 to June 2018 informed PDSA cycles from August 2018 to December 2021. Shewhart process control charts evaluated length of stay (LOS), pharmacologic treatment (PT) rates, direct cost (DC), process, and balancing measures for special cause variation (SCV).
RESULTS: Two hundred and seventeen infants showed downward SCV in LOS (12.6 to 4.4 days), PT (53% to 17%) and DC ($12593.82 to $5219.17). Onset of the COVID-19 pandemic coincided with reversible SCV. DC varied by provider specialty.
CONCLUSION: Transition from MFNASS to ESC led to decrease in healthcare utilization for infants at risk of NOWS. QI methodology identified persistent drivers of variability, including the COVID-19 pandemic and provider specialty.
Author List
Glait M, Moyer A, Saudek K, Cabacungan E, Ryan KAuthors
Erwin Cabacungan MPH, MD Associate Professor in the Pediatrics department at Medical College of WisconsinKris Harlander Saudek MD Professor in the Pediatrics department at Medical College of Wisconsin
Kelsey S. Ryan MD Associate Professor in the Pediatrics department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Analgesics, OpioidHumans
Infant
Infant, Newborn
Neonatal Abstinence Syndrome
Pandemics
Patient Acceptance of Health Care
