| Abstract | The Vermont Oxford Network is a voluntary collaborative group of health professionals committed to improving the effectiveness
and efficiency of medical care for newborn infants and their families through a coordinated program of research, education, and
quality-improvement projects. In support of these activities, the Network maintains a clinical database of information about very low
birth weight infants that now has more than 300 participating neonatal intensive care units (NICUs). We anticipate that these NICUs
will submit data for 25 000 infants with birth weights of 401 to 1500 g born in 1998. The research program of the Network includes
outcomes research and randomized clinical trials. The goal of Network outcomes research is to identify and explain the variations in
clinical practice and patient outcomes that are apparent among NICUs. Network trials are designed to answer practical questions of
importance to practitioners and families using pragmatic designs that can be integrated into the daily practice of neonatology. Quality
improvement is a major focus of the Network. Members receive confidential quarterly and annual reports based on the Network
database that document their performance and compare practices and outcomes at their unit with those at other units within the
Network. These reports are intended to assist the members in identifying opportunities for improvement and to help them monitor the
success of their improvement efforts. Although information is necessary for improvement to occur, it is not sufficient to foster lasting
improvement by itself. Information must be translated into action. The Network is sponsoring an ongoing program of quality initiatives
designed to provide members with the knowledge, skills, tools, and resources needed to foster action for improvement. The Network's
first formal quality-improvement project, the NIC/Q Project, brought together 10 NICUs to apply the methods of collaborative
improvement and benchmarking to neonatal intensive care. Building on the lessons learned in that initial project, the Network now is
conducting the Vermont Oxford Network Evidence-Based Quality Improvement Collaborative for Neonatology, known as NIC/Q
2000. This 2-year collaborative will assist multidisciplinary teams from the 34 participating NICUs to develop four key habits for
improvement: the habit for change, the habit for practice as a process, the habit for collaborative learning, and the habit for
evidence-based practice. During the collaborative, participants will contribute to a knowledge bank of clinical, organizational, and
operational change ideas for improving neonatal care. The coordinated program of research, education, and quality improvement
described in this article is only possible because of the voluntary efforts of the members. The Network will continue to support these
efforts by developing and providing improved tools and resources for the practice of evidence-based neonatology.neonatology, very
low birth weight, database, network, quality improvement, evidence-based medicine, randomization, trials, outcomes, mortality, length
of stay. |