A compilation of professional and academic accomplishments and recognition in the popular press.
Neonatal research was well represented at the 9th Annual Pediatrics Research Retreat at Li Ka Shing Center for Learning and Knowledge on Stanford’s campus on April 26. Vinod Bhutani, MD, MBBS, and Gary Shaw, DrPH, were presenters, and Dr. Shaw also served on the Research Retreat Committee. Faculty, staff, and trainees presented posters at the event.
Antibiotic stewardship and “safely doing less” are the themes of a Pediatrics quality improvement (QI) paper published on April 1. The article reports on a QI project at Lucile Packard Children’s Hospital Stanford that monitored well-appearing late preterm and term infants born to mothers with chorioamnionitis. This differed from current practice, which calls for administering antibiotics to every baby born to a mother with an infection.
With the increasing appreciation for the importance of the gut microbiome in infant health and development as well as the negative and lasting impact of antibiotic exposure on this microbiome, antibiotic stewardship in the newborn is a national initiative. This project helped demonstrate Stanford’s commitment and push on this front. Monitoring led to a significant reduction in unnecessary antibiotic exposure by 55% across all infants ≥ 34 weeks gestation born at the hospital since the QI initiative’s implementation in March 2015. No cases of early-onset sepsis occurred.
The initiative was led by neonatal hospitalists and involved a large team across the Johnson Center for Pregnancy and Newborn Services; Neha Joshi, MD, and Arun Gupta, MD, are co-lead authors on the paper and Adam Frymoyer, MD, is senior author. Dr. Frymoyer presented the results at the annual meeting of the California Association of Neonatologists.
Postdoctoral scholar Krista Sigurdson, PhD, is first author and Jochen Profit, MD, MPH, is senior author on a Journal of Perinatology paper that provides narrative accounts to show disparities in the ways families are treated in the NICU environment. Researchers collected and analyzed 324 stories, the vast majority of which chronicled perceived disparate care that resulted in perceived worse care. Based on analysis, stories were grouped into three broad themes: neglectful care, judgmental care, and systemic barriers to care.
- Read the press release on the study featured on the website for the California Perinatal Quality Care Collaborative (CPQCC).
- The work was done in conjunction with the CPQCC who released a Tip Sheet on Improving Family Centered Care for Diverse Families in the NICU in response to the paper’s publication on April 5.
A review article in the June issue of Clinics in Perinatology explores the success of statewide quality collaboratives in improving the uptake of key perinatal interventions. Authors include clinical fellow Vidya Pai, MD, and faculty members Henry C. Lee, MD, MS Epi, and Jochen Profit, MD, MPH.
While it takes on average 17 years for evidence-based findings to be translated into clinical practice, statewide quality improvement efforts can facilitate strategies for adoption on a multicenter as well as individual hospital level. The article provides evidence to show how neonatology has been a leader in the field of quality improvement and outlines efforts in several states related to antenatal steroid usage and congenital heart disease screening among other quality improvement measures. It concludes with a discussion about the strategies used by statewide collaborations and the barriers to improving care using a state-based quality improvement structure.
In particular, the paper spotlights the work of the California Perinatal Quality Care Collaborative, whose data center is based at Stanford, and has been led by faculty member, Jeffrey Gould, MD, MPH, for the past twenty years. The CPQCC is a prominent leader of statewide neonatal quality improvement and has served as a model for other states’ perinatal collaborative organizations.
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More on these findings: