title: Management of high-order multiple births: application of lessons learned because of participation in Vermont Oxford Network collaboratives.
abstract: OBJECTIVE
  The delivery and care of sextuplets is complex. Potentially better practices that were developed as part of the Vermont Oxford Network improvement collaboratives were used to prepare for a sextuplet delivery at Akron Children's Hospital.
  
  
  METHODS
  The team used potentially better practices that were learned from the Neonatal Intensive Care Quality Improvement Collaborative 2002 using multidisciplinary teams. There was extensive media coverage of the delivery.
  
  
  RESULTS
  The goal was to use nearly all potentially better practices that focused on the goals of reducing nosocomial infection, reducing chronic lung disease, reducing radiograph use, reducing length of stay, reducing blood gas use, promoting nutrition, reducing intraventricular hemorrhage, and enriching family-centered care. The center aimed to use these 97 potentially better practices. Of the 97 possible potential better practices as set by the Neonatal Intensive Care Quality Improvement Collaborative 2002, 96 (99%) were used.
  
  
  CONCLUSIONS
  This is a blueprint that any center that is faced with high-order multiple births could use as a reference point to begin planning. The team created a benchmark to achieve in every birth of very low birth weight infants and not just a special situation of high-order multiple births.
authors.affiliation: Division of Neonatology, Department of Pediatrics, Akron Children's Hospital, One Perkins Square, Akron, OH 44308, USA. akantak@chmca.org
authors.forename: Anand D
authors.initials: AD
authors.lastname: Kantak
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Grow
authors.forename: Judy
authors.initials: J
authors.lastname: Ohlinger
authors.forename: Heather J
authors.initials: HJ
authors.lastname: Adams
authors.forename: Amy M
authors.initials: AM
authors.lastname: Knupp
authors.forename: Justin P
authors.initials: JP
authors.lastname: Lavin
mesh_terms: D036861:Delivery, Obstetric; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D017722:Hospital Charges; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D015931:Intensive Care, Neonatal / Q000458:organization & administration*; D007902:Length of Stay; D008402:Mass Media; D009820:Ohio; D017063:Outcome Assessment, Health Care; D010347:Patient Care Planning; D010348:Patient Care Team; D011247:Pregnancy; D011272:Pregnancy, Multiple; D047928:Premature Birth; D011295:Prenatal Care; D011663:Pulmonary Surfactants / Q000627:therapeutic use; D011785:Quality Assurance, Health Care; D012121:Respiration, Artificial
chemical_list: D005938:Glucocorticoids; D011663:Pulmonary Surfactants