{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T02:01:43Z","timestamp":1787882503349,"version":"build-2784847793"},"reference-count":24,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE:<\/jats:title>\n                    <jats:p>The survival rates for extremely low birth weight (ELBW) infants have improved, but many are discharged from the hospital with significant challenges. Our goal was to improve outcomes for this population by using a multidisciplinary team\u2013based quality improvement approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>A unique program called the Small Baby Unit (SBU) was established in a children\u2019s hospital to care for the ELBW infant born at 28 weeks or less and weighing less than 1000 g at birth. These patients were cared for in a separate location from the main neonatal unit. A core multidisciplinary team that participates in ongoing educational and process-improvement collaboration provides care. Evidence-based guidelines and checklists standardized the approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>Data from the 2 years before and 4 years after opening the SBU are included. There was a reduction in chronic lung disease from 47.5% to 35.4% (P = .097). The rate of hospital-acquired infection decreased from 39.3% to 19.4% (P &amp;lt; .001). Infants being discharged with growth restriction (combined weight and head circumference &amp;lt;10th percentile) decreased from 62.3% to 37.3% (P = .001). Reduced resource utilization was demonstrated as the mean number per patient of laboratory tests decreased from 224 to 82 (P &amp;lt; .001) and radiographs decreased from 45 to 22 (P &amp;lt; .001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Care in a distinct unit by a consistent multidisciplinary SBU team using quality improvement methods improved outcomes in ELBW infants. Ongoing team engagement and development are required to sustain improved outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2014-3918","type":"journal-article","created":{"date-parts":[[2015,9,7]],"date-time":"2015-09-07T20:20:17Z","timestamp":1441657217000},"page":"e1007-e1015","source":"Crossref","is-referenced-by-count":46,"title":["Small Baby Unit Improves Quality and Outcomes in Extremely Low Birth Weight Infants"],"prefix":"10.1542","volume":"136","author":[{"given":"Mindy","family":"Morris","sequence":"first","affiliation":[{"name":"Division of Neonatology, CHOC Children\u2019s Hospital, Orange, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John Patrick","family":"Cleary","sequence":"additional","affiliation":[{"name":"Division of Neonatology, CHOC Children\u2019s Hospital, Orange, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Soliman","sequence":"additional","affiliation":[{"name":"Miller Children\u2019s and Women\u2019s Hospital, Long Beach, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2015,10,1]]},"reference":[{"issue":"3","key":"2021120908423433100_B1","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1542\/peds.2009-2959","article-title":"Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network.","volume":"126","author":"Stoll","year":"2010","journal-title":"Pediatrics"},{"issue":"2","key":"2021120908423433100_B2","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1542\/peds.99.2.149","article-title":"Hospital and patient characteristics associated with variation in 28-day mortality rates for very low birth weight infants.","volume":"99","author":"Horbar","year":"1997","journal-title":"Pediatrics"},{"issue":"5","key":"2021120908423433100_B3","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1542\/peds.106.5.1070","article-title":"Variations in practice and outcomes in the Canadian NICU network: 1996-1997.","volume":"106","author":"Lee","year":"2000","journal-title":"Pediatrics"},{"issue":"4","key":"2021120908423433100_B4","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1542\/peds.113.4.781","article-title":"Center differences and outcomes of extremely low birth weight infants.","volume":"113","author":"Vohr","year":"2004","journal-title":"Pediatrics"},{"key":"2021120908423433100_B5","volume-title":"Crossing the Quality Chasm: A New Health System for the 21st Century","author":"Institute of Medicine, Committee on Quality of Health Care in America","year":"2001"},{"issue":"1","key":"2021120908423433100_B6","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/1471-2431-5-22","article-title":"Variations in rates of nosocomial infection among Canadian neonatal intensive care units may be practice-related.","volume":"5","author":"Aziz","year":"2005","journal-title":"BMC Pediatr"},{"issue":"2","key":"2021120908423433100_B7","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1542\/peds.111.2.339","article-title":"Can changes in clinical practice decrease the incidence of severe retinopathy of prematurity in very low birth weight infants?","volume":"111","author":"Chow","year":"2003","journal-title":"Pediatrics"},{"issue":"3","key":"2021120908423433100_B8","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1542\/peds.2009-1272","article-title":"NICU practices and outcomes associated with 9 years of quality improvement collaboratives.","volume":"125","author":"Payne","year":"2010","journal-title":"Pediatrics"},{"issue":"1","key":"2021120908423433100_B9","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2010-3265","article-title":"Impact of implementing 5 potentially better respiratory practices on neonatal outcomes and costs.","volume":"128","author":"Levesque","year":"2011","journal-title":"Pediatrics"},{"issue":"4","key":"2021120908423433100_B10","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1093\/bja\/aes513","article-title":"Do team processes really have an effect on clinical performance? 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