title: Improving the quality of care for infants: a cluster randomized controlled trial.
abstract: BACKGROUND
  We developed and tested a new method, called the Evidence-based Practice for Improving Quality method, for continuous quality improvement.
  
  
  METHODS
  We used cluster randomization to assign 6 neonatal intensive care units (ICUs) to reduce nosocomial infection (infection group) and 6 ICUs to reduce bronchopulmonary dysplasia (pulmonary group). We included all infants born at 32 or fewer weeks gestation. We collected baseline data for 1 year. Practice change interventions were implemented using rapid-change cycles for 2 years.
  
  
  RESULTS
  The difference in incidence trends (slopes of trend lines) between the ICUs in the infection and pulmonary groups was - 0.0020 (95% confidence interval [CI] - 0.0007 to 0.0004) for nosocomial infection and - 0.0006 (95% CI - 0.0011 to - 0.0001) for bronchopulmonary dysplasia.
  
  
  CONCLUSIONS
  The results suggest that the Evidence-based Practice for Improving Quality method reduced bronchopulmonary dysplasia in the neonatal ICU and that it may reduce nosocomial infection.
authors: Departments of Paediatrics, University of Toronto, Toronto, Ontario, Canada. sklee@mtsinai.on.ca
authors: Shoo K
authors: SK
authors: Lee
authors: Khalid
authors: K
authors: Aziz
authors: Nalini
authors: N
authors: Singhal
authors: Catherine M
authors: CM
authors: Cronin
authors: Andrew
authors: A
authors: James
authors: David S C
authors: DS
authors: Lee
authors: Derek
authors: D
authors: Matthew
authors: Arne
authors: A
authors: Ohlsson
authors: Koravangattu
authors: K
authors: Sankaran
authors: Mary
authors: M
authors: Seshia
authors: Anne
authors: A
authors: Synnes
authors: Robin
authors: R
authors: Walker
authors: Robin
authors: R
authors: Whyte
authors: Joanne
authors: J
authors: Langley
authors: Ying C
authors: YC
authors: MacNab
authors: Bonnie
authors: B
authors: Stevens
authors: Peter
authors: P
authors: von Dadelszen
mesh_terms: D001997:Bronchopulmonary Dysplasia / Q000453:epidemiology / Q000517:prevention & control*; D002170:Canada; D016000:Cluster Analysis; D003428:Cross Infection / Q000453:epidemiology / Q000628:therapy*; D019317:Evidence-Based Medicine / Q000379:methods* / Q000592:standards; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D008297:Male; D011446:Prospective Studies; D011785:Quality Assurance, Health Care / Q000706:statistics & numerical data*