User-friendly computerized quality assurance program for regionalized neonatal care.

Abstract

In October 1983 a computerized data base system was implemented to perform quality assurance in the neonatal referral region of the University of Michigan. This system was customized to match and expand forms and reports already in use. It is menu driven, requires only rudimentary skills, and is compatible with existing computer equipment. To assess the effectiveness of the program in monitoring and improving neonatal care within the region, data from the first full year (1984) were compared with data from the last full year (1990). Statistically significant changes were found for referring physician presence at transfer, a greater assumption of initial stabilization procedures by community hospital personnel (continuous cardiorespiratory monitoring, orogastric tube placement, provision of respiratory support, blood glucose screening, blood gas evaluation, blood culturing, and antibiotic therapy), and an overall improvement in patient status before transfer. Review of reports generated by data analysis enables design of educational programs that are hospital specific and that focus on problems or deficiencies determined during quality assurance conferences. The chief benefit of this system is the provision of an objective basis for constructive criticism, which leads to both cognitive and behavioral changes in care providers and ultimately improves the delivery of care to neonates.