A multidisciplinary quality improvement effort to reduce bronchopulmonary dysplasia incidence

Background Bronchopulmonary Dysplasia (BPD) is the most common prematurity complication. Although several practices have been proposed for BPD prevention, none of these in isolation prevent BPD. Methods Our initiative focused on two key drivers: oxygen management and noninvasive ventilation strategies. We created best practice guidelines and followed outcome measures using Shewhart control charts. Results PDSAs of protocols preceded a large-scale rollout of a "0.21 by 28" campaign in 2014 leading to a special cause reduction in the "any BPD" rate, and a decrease in severe BPD (from 57 to 29%). At the end of 2017, we reinvigorated the project, which led to dramatic decreases in the "any BPD" rate to 41% and the "severe BPD" rate to 21%. Conclusions A multidisciplinary QI initiative focused on process improvement geared towards the pathophysiological contributors of BPD has successfully reduced the rate of BPD in an all referral level IV NICU.