{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T02:13:29Z","timestamp":1767838409555,"version":"3.49.0"},"reference-count":46,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,3,1]]},"abstract":"<jats:sec><jats:title>OBJECTIVE:<\/jats:title><jats:p>Quality improvement collaboratives (QICs) can improve short-term outcomes, but few have examined their long-term results. This study evaluated the changes in treatment practices and outcomes associated with participation in multiple sequential QICs.<\/jats:p><\/jats:sec><jats:sec><jats:title>DESIGN AND METHODS:<\/jats:title><jats:p>This retrospective, 9-year, pre-post study of very low birth weight infants, we assessed treatment and outcomes from the 8 NICUs of the Reduce Lung Injury (ReLI) group of a QIC sponsored by the Vermont Oxford Network (VON). We analyzed data from 1998 (pre-ReLI), 2001 (last ReLI year), and 2006 (5 years after ReLI) by using univariate and multiple regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>A total of 4065 very low birth weight infants were treated in ReLI NICUs in 1998, 2001, and 2006. From 1998 to 2006, the ReLI group decreased delivery room intubation (70% vs 52%; adjusted odds ratio [aOR]: 0.2 [95% confidence interval (CI): 0.2\u20130.3]; P &amp;lt; .001), conventional ventilation (75% vs 62%; aOR: 0.3 [95% CI: 0.2\u20130.4]; P &amp;lt; .001), and postnatal steroids for BPD (35% vs 10%; aOR: 0.09 [95% CI: 0.07\u20130.1]; P &amp;lt; .001). They increased the use of nasal continuous positive airway pressure (57% vs 78%; aOR: 3.3 [95% CI: 2.7\u20133.9]; P &amp;lt; .001). BPD-free survival remained unchanged (68% vs 66%; aOR: 0.9 [95% CI: 0.7\u20131.1]; P = .16), the BPD rate increased (25% vs 29%; aOR: 1.3 [95% CI: 1.1\u20131.6]; P = .017), survival to discharge increased (90% vs 93%; aOR: 1.5 [95% CI: 1.1\u20132.2]; P &amp;lt; .001), and nosocomial infections decreased (18% vs 15%; aOR: 0.8 [95% CI: 0.6\u20130.99]; P = .045).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS:<\/jats:title><jats:p>Participation in VON\u2013sponsored QICs was associated with sustained implementation of potentially better respiratory practices, increased survival, and reduced nosocomial infections. The BPD-free survival rate did not change, and the BPD rate increased. Implemented changes endured for at least 5 years after the QIC.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.2009-1272","type":"journal-article","created":{"date-parts":[[2010,2,2]],"date-time":"2010-02-02T01:51:52Z","timestamp":1265075512000},"page":"437-446","source":"Crossref","is-referenced-by-count":70,"title":["NICU Practices and Outcomes Associated With 9 Years of Quality Improvement Collaboratives"],"prefix":"10.1542","volume":"125","author":[{"given":"Nathaniel R.","family":"Payne","sequence":"first","affiliation":[{"name":"Departments of Neonatology and"},{"name":"Clinical Care Innovation and Research, Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marsha J.","family":"Finkelstein","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Michigan State University, East Lansing, Michigan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meixia","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Michigan State University, East Lansing, Michigan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph W.","family":"Kaempf","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Providence St Vincent's Medical Center, Portland, Oregon; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul J.","family":"Sharek","sequence":"additional","affiliation":[{"name":"Division of General Pediatrics, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sam","family":"Olsen","sequence":"additional","affiliation":[{"name":"Departments of Neonatology and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2010,3,1]]},"reference":[{"key":"2021120905423359200_B1","volume-title":"Crossing the Quality Chasm: A New Health System for the 21st Century","author":"Institute of Medicine","year":"2001"},{"issue":"1","key":"2021120905423359200_B2","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1542\/peds.79.1.26","article-title":"Is chronic lung disease in low birth weight infants preventable? 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