Policy, Health Services and Outcomes
Over 500,000 babies (representing one in seven births in the U.S.) are born in California each year, and 10-12 percent of these infants are admitted to some level of NICU care, including intermediate NICUs. We are thus presented with a great opportunity to study outcomes, design innovative tools for quality care improvement, and assess the effects of public policy shifts.
Stanford University is the coordinating center for the California Perinatal Quality Care Collaborative (CPQCC), providing leadership from within our Outcomes and Perinatal Epidemiology Research Unit and helping to facilitate statewide collaboration. Created by the California Association of Neonatologists in 1997, CPQCC has grown significantly in membership and resources. The collaborative now collects data from 132 NICUs, representing over 90 percent of those in the state. This makes for a diverse, real-time, population-based data system.
CPQCC also collects data to identify opportunities for improving the quality of care for the over 6,000 yearly acute neonatal transports, making the collaborative the largest neonatal transport monitoring system in the U.S. Additionally, Stanford is the center for the California Maternal Quality Care Collaborative (CMQCC), which works to ensure equitable care for mothers and prevent maternal death.
At Stanford we are invested in mining big data. We make assessments using innovative analytic tools, and incorporate all California perinatal databases with Vermont Oxford Network existing data systems. By linking CPQCC databases to vital records collected by the Office of Statewide Health Planning and Development, we have even more opportunities to assess prenatal, neonatal and post-natal care delivery. We run a High-Risk Infant Follow-up Quality Care Initiative where we explore the development of at-risk newborns. Data collection continues up until these children’s third birthday.
We translate our findings in several ways. A committee within CPQCC runs community outreach programs that disseminate QI-science via trainings and toolkits. We also communicate directly with NICUs, focusing on overall performance based on a composite measure of NICU quality of care delivery. Finally, our faculty works with Washington lawmakers, influencing policy regarding the regionalization of children’s health services. Our partnership with the Center for Health Policy / Center for Primary Care and Outcomes Research is addressing contemporary questions about large networks being responsible for the general wellbeing of our nation’s most vulnerable.