{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:23:56Z","timestamp":1777944236786,"version":"3.51.4"},"reference-count":36,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T00:00:00Z","timestamp":1760400000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neonatal-Perinatal Medicine"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>To reduce avoidable Special Newborn Care Unit (SNCU) admissions by 15% over a 4-month period through focused quality improvement (QI) interventions at a high-volume tertiary care hospital in Kolkata, India.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This QI study was conducted from August to November 2024. Baseline data revealed that 25% of weekly SNCU admissions were avoidable. A multidisciplinary team implemented evidence-based admission criteria, enhanced perinatal care practices, and strengthened postnatal monitoring. Key interventions included improved delivery room practices (respiratory support with CPAP, delayed cord clamping, early skin-to-skin contact, and early initiation of breastfeeding) and standardized triage protocols. Feeding support, prefeeding oromotor stimulation, antibiotic stewardship, and reverse transport to nearby SNCUs were also integrated. Four Plan-Do-Study-Act (PDSA) cycles supported infrastructure planning, staff training, protocol implementation, and sustainability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Avoidable admissions declined from 25% to 10% over 4-months. Bed occupancy dropped from a peak of 125% to 102%. Process indicators improved significantly: delayed cord clamping increased from 30% to 88%, early initiation of breastfeeding from 40% to 90%, and exclusive breastfeeding at discharge from 67% to 81%. Admissions for neonatal jaundice decreased following the implementation of updated AAP guidelines, with 21% of cases managed without phototherapy. Only five re-admissions (0.59%) and one emergency NICU transfer (0.13%) occurred.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Neonatal care should extend beyond SNCU optimization to include strengthened delivery point and postnatal-ward practices. When integrated with protocol based SNCU management, this continuum helps reduce morbidity, ease overcrowding, enhance efficiency, and optimize resource utilization in high-burden, resource-limited settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19345798251387331","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T08:18:31Z","timestamp":1760429911000},"page":"313-322","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of a quality improvement initiative on neonatal stabilization and admission patterns in a special care newborn unit in India"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8658-5713","authenticated-orcid":false,"given":"Md Habibullah","family":"Sk","sequence":"first","affiliation":[{"name":"Institute of Post Graduate Medical, Education & Research and SSKM Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8104-9225","authenticated-orcid":false,"given":"Bijan","family":"Saha","sequence":"additional","affiliation":[{"name":"Institute of Post Graduate Medical, Education & Research and SSKM Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2069-5172","authenticated-orcid":false,"given":"Anindya Kumar","family":"Saha","sequence":"additional","affiliation":[{"name":"Institute of Post Graduate Medical, Education & Research and SSKM Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,10,14]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2016.186"},{"key":"e_1_3_4_3_2","unstructured":"Government of India. ministry of health and family welfare. https:\/\/sansad.in\/getFile\/loksabhaquestions\/annex\/184\/AS69_lqLcKA.pdf?source=pqals (last accessed 16th June 2025)."},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30471-2"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)31050-3"},{"key":"e_1_3_4_6_2","unstructured":"https:\/\/sansad.in\/getFile\/loksabhaquestions\/annex\/184\/AS69_lqLcKA.pdf?source=pqals (accessed 11th January 2025)."},{"key":"e_1_3_4_7_2","unstructured":"https:\/\/nhm.gov.in\/New-Update-2022-24\/CH-Programmes\/Resource-Material-MusQan\/Musqan-JNS.pdf (accessed 10th April 2025)."},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2015.1305"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2017.3913"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2017.08.028"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1542\/hpeds.2015-0058"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2019.0106"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)71881-X"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)02468-6"},{"key":"e_1_3_4_15_2","first-page":"CD004074","article-title":"Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes","volume":"7","author":"McDonald SJ","year":"2013","unstructured":"McDonald SJ, Middleton P, Dowswell T, et al. 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