title: Implementing Delivery Room Checklists and Communication Standards in a Multi-Neonatal ICU Quality Improvement Collaborative.
abstract: BACKGROUND
  The 2015 American Academy of Pediatrics Neonatal Resuscitation Program (NRP) and International Liaison Committee on Resuscitation (ILCOR) resuscitation guidelines state, "It is still suggested that briefing and debriefing techniques be used whenever possible for neonatal resuscitation." Effective communication and reliable delivery of evidence-based best practices are critical aspects of the 2015 NRP guidelines. To promote optimal communication and best practice-focused checklists use during active neonatal resuscitation, the Readiness Bundle (RB) was integrated within the larger change package deployed in the California Perinatal Quality Care Collaborative's (CPQCC) 12-month Delivery Room Management Quality Improvement Collaborative.
  
  
  METHODS
  The RB consisted of (1) a checklist for high-risk neonatal resuscitations and (2) briefings and debriefings to improve teamwork and communication in the delivery room (DR). Implementation of the RB was encouraged, compliance with the RB was tracked monthly up through 6 months after the completion of the collaborative, and satisfaction with the RB was evaluated.
  
  
  RESULTS
  Twenty-four neonatal intensive care units (NICUs) participated in the CPQCCDR collaborative. Before the initiation of the collaborative, the elements of the RB were complied with in 0 of 740 reported deliveries (0%). During the 12-month collaborative, compliance with the RB improved to a median of 71%, which was surpassed in the 6-month period after the collaborative ended (80%). One-hundred percent of responding NICUs would recommend the RB to other NICUs working on improving DR management.
  
  
  CONCLUSIONS
  The RB was rapidly adopted, with compliance sustained for 6 months after completion of the collaborative. Inclusion of the RB in the next generation of the NRP guidelines is encouraged.
authors.affiliation: Division of Neonatology, Department of Pediatrics, John Muir Medical Center, Walnut Creek, California, USA.
authors.forename: Stacie C
authors.initials: SC
authors.lastname: Bennett
authors.forename: Neil
authors.initials: N
authors.lastname: Finer
authors.forename: Louis P
authors.initials: LP
authors.lastname: Halamek
authors.forename: Nick
authors.initials: N
authors.lastname: Mickas
authors.forename: Mihoko V
authors.initials: MV
authors.lastname: Bennett
authors.forename: Courtney C
authors.initials: CC
authors.lastname: Nisbet
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Sharek
mesh_terms: D057189:Checklist; D003142:Communication; D003696:Delivery Rooms / Q000592:standards*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000592:standards*; D064872:Patient Care Bundles; D010348:Patient Care Team / Q000592:standards; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D058996:Quality Improvement; D012151:Resuscitation / Q000592:standards; D014481:United States