title: Newborn intensive care survivors: a review and a plan for collaboration in Texas.
abstract: BACKGROUND
  Neonatal intensive care is a remarkable success story with dramatic improvements in survival rates for preterm newborns. Significant efforts and resources are invested to improve mortality and morbidity but much remains to be learned about the short and long-term effects of neonatal intensive care unit (NICU) interventions. Published guidelines recommend that infants discharged from the NICU be in an organized follow-up program that tracks medical and neurodevelopmental outcomes. Yet, there are no standardized guidelines for provision of follow-up services for high-risk infants. The National Institute of Child Health and Human Development Neonatal Research Network and the Vermont Oxford Network have made strides toward standardizing practices and conducting outcomes research, but only include a subset of developmental follow-up programs with a focus on extremely preterm infants. Several studies have been conducted to gain a better understanding of current practices in developmental follow-up. Some of the major themes in these studies are the lack of personnel and funding to provide comprehensive follow-up care; feeding difficulties as a primary issue for NICU survivors, families, and programs; wide variability in referral and follow-up care practices; and calls for standardized, systematic developmental surveillance to improve outcomes.
  
  
  RESULTS
  We convened a one-day summit to discuss developmental follow-up practices in Texas involving four academic and three nonacademic centers. All seven centers described variable age and weight criteria for follow-up of NICU patients and a unique set of developmental practices, including duration of follow-up, types and timing of developmental assessments administered, education and communication with families and other health care providers, and referrals for services. Needs identified by the centers focused on two main themes: resources and comprehensive care. Participants identified key challenges for developmental follow-up, generated recommendations to address these challenges, and outlined components of a quality program.
  
  
  CONCLUSIONS
  The long-term goal is to ensure that all children maximize their potential; a goal supported through quality, comprehensive developmental follow-up care and outcomes research to continuously improve evidence-based practices. We aim to contribute to this goal through a statewide working group collaborating on research to standardize practices and inform policies that truly benefit children and their families.
authors.affiliation: Department of Pediatrics, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr., San Antonio Texas, 78229 USA.
authors.forename: Alice
authors.initials: A
authors.lastname: Gong
authors.affiliation: Cook Children's Hospital, 1500 Cooper St., Dodson Specialty Building, 2nd Floor, Fort Worth, TX 76104 USA.
authors.forename: Yvette R
authors.initials: YR
authors.lastname: Johnson
authors.affiliation: Department of Pediatrics, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr., San Antonio Texas, 78229 USA.
authors.forename: Judith
authors.initials: J
authors.lastname: Livingston
authors.affiliation: Department of Pediatrics, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr., San Antonio Texas, 78229 USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Matula
authors.affiliation: The University of Texas Health Science Center-Houston, 6431 Fannin St.,, Houston Texas, 77030 USA.
authors.forename: Andrea F
authors.initials: AF
authors.lastname: Duncan
keywords: Collaboration; Developmental follow-up; Outcomes research; Preterm birth; Standardized practice