Estimating the quality of neonatal transport in California.
OBJECTIVE
To develop a strategy to assess the quality of neonatal transport based on change in neonatal condition during transport.


METHODS
The Canadian Transport Risk Index of Physiologic Stability (TRIPS) score was optimized for a California (Ca) population using data collected on 21 279 acute neonatal transports, 2007 to 2009, using models predicting (2/3) and validating (1/3) mortality within 7 days of transport. Quality Change Point 10th percentile (QCP10), a benchmark of the greatest deterioration seen in 10% of the transports by top-performing teams, was established.


RESULTS
Compared with perinatal variables (0.79), the Ca-TRIPS had a validation receiver operator characteristic area for prediction of death of 0.88 in all infants and 0.86 in infants transported after day 7. The risk of death increased 2.4-fold in infants whose deterioration exceeded the QCP10.


CONCLUSIONS
We present a practical, benchmarked, risk-adjusted, estimate of the quality of neonatal transport.
1] Department of Pediatrics, Division of Neonatal-Perinatal Medicine Stanford University School of Medicine, Stanford, CA, USA [2] California Perinatal Quality Care Collaborative, Palo Alto, CA, USA.
J B
JB
Gould
B H
BH
Danielsen
L
L
Bollman
A
A
Hackel
B
B
Murphy
D019985:Benchmarking / Q000379:methods*; D002140:California; D002170:Canada; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D016015:Logistic Models; D011787:Quality of Health Care / Q000592:standards*; D012372:ROC Curve; D020379:Risk Adjustment; D014187:Transportation of Patients / Q000592:standards*