Length of Stay Clinical Trial
— ABC-QIOfficial title:
Alberta (AB) Collaborative Quality Improvement Strategies to Improve Outcomes of Preterm Infants 32 - 36 Weeks' Gestation: A Stepped-Wedge Cluster Randomized Trial
Verified date | January 2024 |
Source | University of Calgary |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
The ABC-QI Trial aims to implement collaborative quality improvement (QI) strategies to standardize care for 32-36 week infants in Level 2 and 3 Neonatal intensive care units (NICUs) across the province of Alberta. The investigators want to know if using validated quality improvement methods and evidence-based care bundles will decrease the duration of hospital stay and get babies home as quickly as possible.
Status | Enrolling by invitation |
Enrollment | 9500 |
Est. completion date | August 30, 2027 |
Est. primary completion date | August 30, 2027 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 32 Weeks to 36 Weeks |
Eligibility | Inclusion Criteria: Preterm Infants: Infants born at 32 to 36 weeks' gestation and admitted to the participating NICUs or postpartum units. Quality Improvement Implementation Survey version 2 (QIIS-II) and semi-structured interview participants: Management staff, nurses, nurse practitioners, physicians, and allied health staff employed in participating NICUs. Exclusion Criteria: - Preterm Infants: - Major congenital anomalies or chromosomal abnormalities. - Primary admission to a surgical NICU: Alberta Children's Hospital or Stollery Children's Hospital. - Infants born in or transferred to a NICU outside Alberta. |
Country | Name | City | State |
---|---|---|---|
Canada | Foothills Medical Centre | Calgary | Alberta |
Lead Sponsor | Collaborator |
---|---|
University of Calgary | Alberta Health services, Covenant Health, University of Alberta |
Canada,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Length of Stay | The duration of hospitalization until final discharge. | Birth until discharge home or death, whichever came first, assessed until the participant reaches a corrected age of 6 months (6 months after their birth due date). | |
Secondary | Cost to healthcare system per participant | The investigators will use the Canadian Institute for Health Information Patient Cost Estimator to calculate the daily cost based on the Case Mix Groups for gestational age and birth weight. | Birth until discharge home or death, whichever came first, assessed until the participant reaches a corrected age of 6 months (6 months after their birth due date). | |
Secondary | Number of participants with Hypothermia | Axillary temperature <36.5°C. | Within 1 hour of birth | |
Secondary | Number of participants with Hypoglycemia | Blood glucose <2.6 mmol/L. | First 24 hours of age | |
Secondary | Surfactant administration | Date and method of administration | First 168 hours of age. | |
Secondary | Duration of respiratory support | Total number of days administered | Birth until discharge home or death, whichever came first, assessed until the participant reaches a corrected age of 6 months (6 months after their birth due date). | |
Secondary | Age at achieving full enteral feeding | Date when the enteral intake reaches 120 ml/kg/day. | Birth until discharge home or death, whichever came first, assessed until the participant reaches a corrected age of 6 months (6 months after their birth due date). | |
Secondary | Time to regain birth weight | Difference in days between birth date and date when the infants regains or exceeds birth weight after initial weight loss. | Birth until discharge home or death, whichever came first, assessed until the participant reaches a corrected age of 6 months (6 months after their birth due date). | |
Secondary | Weight in grams | actual values in grams | At discharge home in survivors, assessed up to a corrected age of 6 months (6 months after their birth due date). | |
Secondary | Length in centimeters | actual values in centimeters | At discharge home in survivors, assessed up to a corrected age of 6 months (6 months after their birth due date). | |
Secondary | Head circumference in centimeters | actual values in centimeters | At discharge home in survivors, assessed up to a corrected age of 6 months (6 months after their birth due date). | |
Secondary | Breastmilk use | Defined as number of feeds where infant received breastfeeding or maternal expressed breastmilk | Birth until discharge home or death, whichever came first, assessed until the participant reaches a corrected age of 6 months (6 months after their birth due date). | |
Secondary | Number of unplanned rehospitalizations per participant | Unplanned readmission to any hospital in Alberta following discharge | Within 30 days after discharge home | |
Secondary | Number of emergency room visits per participant | Emergency room visits to any hospital in Alberta following discharge | Within 30 days after discharge home | |
Secondary | Hospital mortality | Proportion of infants who dies before first discharge home | Until first discharge home, assessed until the participant reaches a corrected age of 6 months (6 months after their birth due date). | |
Secondary | Infant mortality before 1 year of corrected age | Corrected age = chronological age - days required for an infant to complete postmenstrual age of 40 weeks. | Before 1 year of corrected age | |
Secondary | Transfer from Level II to Level III NICU | Proportion of infants who require escalation of care and transfer to Level III NICU. | Until first discharge home, assessed until the participant reaches a corrected age of 6 months (6 months after their birth due date). | |
Secondary | Staff perception of collaborative QI (EPIQ) implementation. | Semi-structured interviews with selected sample of staff from each NICU | Year 2, 3, and 4 of study |
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