Finding treasure in the journey: a single center quality improvement bundle to reduce bronchopulmonary dysplasia

J Perinatol. 2024 Nov 26. doi: 10.1038/s41372-024-02190-0. Online ahead of print.

Abstract

Background: Reducing bronchopulmonary dysplasia (BPD) utilizing a single intervention has been challenging. The quality improvement (QI) bundle approach may better address BPD multifactorial risk factors.

Methods: A single-center interdisciplinary quality improvement (QI) initiative to enhance respiratory care for preterm infants born less than 30 weeks gestation.

Global aim: To reduce BPD in preterm infants.

Smart aim: Introduce and implement a comprehensive, evidence-based respiratory care bundle within 12 months, targeting areas needing improvement in our practices.

Results: Our preplanned improvement targets were achieved for all process measures. Overall BPD incidence did not change (45% vs. 44.3%). After the QI intervention, inborn infants had a lower BPD rate, though not statistically significant (38.7% vs. 30.3%, p = 0.22), with a significant reduction in grade 1 BPD (24.5% vs. 12.4%, p = 0.032).

Conclusion: Structured interdisciplinary QI work tailored to local settings can improve respiratory care and possibly amend the outcomes of infants at risk for BPD.