Quality and Performance Improvement Education and Experience

Fellows in the Neonatal-Perinatal Medicine Fellowship will participate in a Quality Improvement (QI) project during the course of their fellowship and will be well supported in this endeavor. Trainees will have the opportunity to participate at both the local and regional/national levels in QI efforts. By providing updates on their work at least quarterly to our Multidisciplinary QI Group, fellows will receive regular feedback and guidance for their projects.

The Division of Neonatology at Children’s Hospital Los Angeles has an established reputation for excellence in QI and performance improvement. Projects are driven by leaders within our division who assemble multidisciplinary teams to run them. Our division has a faculty member in a QI leadership role at the hospital level. Those faculty members serve as teachers and role models and are visible and accessible mentors for the trainees throughout their fellowship. In addition to multidisciplinary QI projects within our own NICUs (at all three sites), we also regularly participate in multi-institutional multi-disciplinary QI collaboratives with the California Perinatal Quality Improvement Committee (CPQCC) and the Children’s Hospital Neonatal Consortium (CHNC).

Fellows will have the opportunity to engage in daily performance improvement activities during rounds where key quality/performance issues, such as necessity of central line, availability and support around provision of breastmilk, review of all medications and necessity of such, eligibility for safe sleep, bone health and risk for osteopenia/fractures, growth velocity, are reviewed with the interdisciplinary team.

Additionally, fellows will participate actively in our monthly multi-disciplinary PI/QI meeting where all key quality metrics, hospital acquired conditions, morbidities and mortalities, and QI collaborative metrics are reviewed and put into perspective with comparative data available through the multiple consortiums that we belong to (i.e. CPQCC, CHNC, Vermont Oxford Network). This offers the opportunity to identify areas for additional quality improvement work.

Fellows also have the opportunity and are expected to participate in both bedside Root Cause Analysis (RCAs) held within the NICUs with our Quality and Safety Department, as well as larger scale hospital-based RCAs.