Neonatal Golden Hour Initiatives and Practices Overview

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Explore the ILPQC Golden Hour Teams Call held on February 20, 2018, highlighting the introduction of a new project coordinator, communication practices, delivery room practices, and family engagement initiatives within the ILPQC Golden Hour framework. Key metrics and goals from 2015-2017 are presented, emphasizing the importance of checklist utilization, timely interventions, and family involvement in neonatal care.

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ILPQC Golden Hour Teams Call February 20, 2018 2:00 3:00 pm

Introductions Please enter into the chat box your Name Role Institution If you are only on the phone line, please be sure to let us know so we can note your attendance

Welcome to Our New ILPQC Project Coordinator! Welcome Danielle Young, MPH, ILPQC Project Coordinator! Danielle will be the lead coordinator on Hypertension and IPLARC but will help with other initiatives as needed Danielle.Young@northwestern.edu Dan Weiss will continue to be the lead coordinator on Golden Hour and MNO initiatives dweiss@northshore.org

Introductions Golden Hour data Finishing strong Sustainability Announcements

GOLDEN HOUR DATA 5

Neonatal Golden Hour: Communication Practices ILPQC: Golden Hour Initiative Communication Practices: Percent of Deliveries Utilizing Delivery Room Checklist, Prebrief, & Debrief All Hospitals, 2015-2017 100% 90% 80% 70% Percent of Deliveries 60% 50% 40% 30% 20% 10% 0% Checklist Prebrief Debrief Goal

Neonatal Golden Hour: Delivery Room Practices ILPQC: Golden Hour Initiative Delivery Room Practices: Percent of Eligible Infants with Temp Probe Initiated within 10 minutes, Initially Stabilized with CPAP Trial, & Delayed Cord Clamping 30+ Seconds All Hospitals, 2015-2017 100% 90% 80% Percent of Eligible Infants 70% 60% 50% 40% 30% 20% 10% 0% Temp Probe CPAP All Delayed Cord Clamping Goal

Neonatal Golden Hour: Family Engagement ILPQC: Golden Hour Initiative Family Practices: Percent of Families Receiving Pre-Contact, Present During Admission, and Present During Resuscitation All Hospitals, 2015-2017 100% 90% 80% 70% Percent of Families 60% 50% 40% 30% Wow! 20% 10% 0% Family Pre-Contact Family Resuscitation Family Admission Goal

Neonatal Golden Hour: Admission Practices Temperature and IV Glucose ILPQC: Golden Hour Initiative Admission Practices: Percent of Admitted Infants who are Between 36.5- 37.5 C on Admission (<32 weeks) & who Received IV Glucose within 1 Hour of NICU/Specialty Care Nursery Admission All Hospitals, 2015 - 2017 100% 90% 80% Percent of Admitted Infants 70% 60% 50% 40% 30% 20% 10% 0% IV Glucose Temperature Goal

Finishing Strong All 2017 Golden Hour data submitted to REDCap by March 15, 2018 Follow-up with teams with missing data through March 31, 2018, when current data system will be closed Transition to sustainability data system on April 1, 2018, pending availability of sustainability reports 2018 data can be entered at this time

Checklist to Complete Golden Hour Initiative Submit ILPQC Golden Hour Data Form data through December 2017 by March 15, 2018 in REDCap Facilitate completion of education with all providers and nurses Review data for 3 key process measures with your team Connect with your Perinatal Network Administrator if you are not yet at the 80% debrief, delayed cord clamping, or temperature goal Develop sustainability plan with your QI team (draft plan provided by ILPQC), submit to your Perinatal Network Administrator Continue to collect / submit data on sustainability measures for compliance monitoring. Compliance data form and reports active on April 1

Supporting Teams to Sustain Improvement QI Support for teams ILPQC will review measures on a quarterly basis to identify teams not at goals for outreach Perinatal Network Administrators will connect with teams still working towards GH Goals All teams that (1) submit all data through December 2017 by March 15, 2018, and (2) meet or exceed the 80% delivery room debrief, 80% delayed cord clamping, and 80% temperature goals by December 2018 will receive (when both criteria are met) an ILPQC QI Excellence Award Certificate and Letter of Commendation to their hospital administration congratulating them for achievements for the Golden Hour Initiative!

Sustained Improvement Metrics Data form will collect data on these process measures: Delivery Room Debrief Delayed Cord Clamping Temperature at NICU/Specialty Care Nursery Admission Monitor sustainability reports for these goals: 80% of all high risk deliveries completing delivery room debrief 80% of infants < 32 weeks gestational age receiving delayed cord clamping for 30+ seconds 80% of infants < 32 weeks gestational age admitted to the NICU/SCN with temperature between 36.5 - 37.5 degrees Celsius

Delayed Cord Clamping Item Wording for Sustainability Delayed cord clamping done? Yes (30 + seconds) No (<30 seconds or not attempted)

Adding new Record ID 3691 Record ID Hospital ID Number * must provide value 3691 Date of birth * must provide value TodayM-D-Y Adding new Record ID 3691 Record ID Hospital ID Number * must provide value Birth weight * must provide value 3691 Weight in grams at birth DRAFT: Golden Hour Sustainability Data Form in REDCap Date of birth * must provide value Resuscitation * must provide value Yes TodayM-D-Y No reset Birth weight * must provide value Gestational age in weeks * must provide value days * must provide value Gender * must provide value Answer yes if baby required any care beyond stimulation and Weight in grams at birth suctioning Yes Resuscitation * must provide value No reset Answer yes if baby required any care beyond stimulation and suctioning Gender of infant Gestational age in weeks * must provide value days * must provide value Gender * must provide value * must provide value Race * must provide value Race of mother Yes Admitted Gender of infant No reset Race * must provide value Answer yes if infant was admitted to Neonatal ICU or Special Race of mother Care Nursery Delivery Room Care Yes Admitted * must provide value Debrief done No Yes reset Answer yes if infant was admitted to Neonatal ICU or Special Care Nursery No reset Discussion of delivery with team occurred after delivering Delivery Room Care Yes Yes (30+ Seconds) Debrief done Delayed cord clamping done? No No (< 30 Seconds or Not Attempted) reset Discussion of delivery with team occurred after delivering Admission reset Admission Temperature * must provide value Temperature Axillary temperature measured at 30 minutes of age +/- 15 Yes (30+ Seconds) minutes. Answer N/A if not admitted Axillary temperature measured at 30 minutes of age +/- 15 minutes. Answer N/A if not admitted Delayed cord clamping done? * must provide value No (< 30 Seconds or Not Attempted) reset Admission Temperature * must provide value Axillary temperature measured at 30 minutes of age +/- 15 minutes. Answer N/A if not admitted

Congratulations! Updated GH QI Awards BRONZE: Advocate Condell Medical Center Special Care Nursery St. John s Children s Hospital Advocate Illinois Masonic Medical Center Northwestern Medicine Delnor Hospital SILVER: AMITA Alexian Brother Women s and Children s Hospital Edward Hospital GOLD: Northwestern Memorial Hospital AMITA Health Adventist Medical Center Hinsdale

Congratulations! Updated GH QI Awards All Quality Improvement Award winners and their award levels (e.g. Gold) will be acknowledged via: ILPQC website Neonatal GH monthly email Annual Conference slides on website Special recognition at the Face to Face! For the three teams not receiving a banner at the Annual Conference a banner will be printed and shipped to their hospital

Golden Hour Sustainability Calls Transitioning from monthly to quarterly Team Meetings by Q2 2018 2018 Golden Hour sustainability call schedule for data review, team talks Tuesday, February 20th, 2-3pm Tuesday, March 20th, 2-3pm Tuesday, June 19th, 2-3pm Tuesday, September 18th, 2-3pm Tuesday, December 18th, 2-3pm What are helpful topics to cover during sustainability and months where there is no call?

Golden Hour Sustainability Team Talks - TENTATIVE Call Month Suggested Teams Suggested Topics Additional topics? Topics to omit? Suggestions for changes in team talk structure? Other feedback? March - St. John s Children s Hospital AMITA Alexian Brother Women s and Children s Hospital - - Share sustainability plan? Team Debrief: how are teams achieving success? - June - Northwestern Memorial Hospital Carle Foundation Hospital - Maintaining provider /nurse engagement? New Hire Education plans? - - Septem ber -Advocate Condell Medical Center- SCN -Advocate Illinois Masonic Medical Center - Maintaining gains in Delayed Cord Clamping? End of Year -Edward Hospital -NM Delnor Hospital -AMITA Health Adventist Hinsdale - Continuing provider/nursing education strategies?

Next Steps: Submit all 2017 Golden Hour data to REDCap by March 15, 2018 Will follow-up with teams with missing data through March 31, 2018, when current data system will be closed Teams will transition to sustainability data system on April 1, 2018, pending availability of sustainability reports Bring a draft of your sustainability plan to March 2018 Golden Hour Teams Call!