A quality improvement study on improving the follow-up rate of preterm infants after discharge.
10.7499/j.issn.1008-8830.2410046
- Author:
He-Sheng CHANG
1
;
Xue YANG
1
;
Jun JU
1
;
Wen-Ya XU
1
;
Di WU
1
;
Xiao-Man WAN
1
;
Zheng-Hong LI
Author Information
1. Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College/State Key Laboratory of Complex Severe and Rare Diseases Beijing 100730 China.
- Publication Type:Journal Article
- Keywords:
Discharge;
Follow-up rate;
Preterm infant;
Quality improvement
- MeSH:
Humans;
Quality Improvement;
Infant, Premature;
Infant, Newborn;
Patient Discharge;
Follow-Up Studies;
Female;
Male
- From:
Chinese Journal of Contemporary Pediatrics
2025;27(2):148-154
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVES:To explore the measures to improve the follow-up rate of preterm infants after discharge, and to evaluate the effectiveness of these measures using quality improvement methodology.
METHODS:The follow-up status of preterm infants discharged from March to May 2017 was used as the baseline before quality improvement, and a specific quality improvement goal for the follow-up rate was proposed. The Pareto chart was used to analyze the causes of follow-up failure, and a key driver diagram was constructed based on the links involved in improving follow-up rate. The causes of failure were analyzed to determine the key links and intervention measures for quality improvement, and the follow-up rate was monitored weekly using a control chart until the quality improvement goal was achieved.
RESULTS:The follow-up rate of preterm infants after discharge was 57.92% (117/202) at baseline before quality improvement, and the quality improvement goal was set to increase the follow-up rate of preterm infants from baseline to more than 80% within 12 months. The Pareto chart analysis showed that the main causes of follow-up failure were deficiencies in follow-up file management and irregular follow-up times (33.70%, 31/92), insufficient follow-up education and poor communication (25.00%, 23/92), and the inability to meet the diverse needs of parents (18.48%, 17/92). Based on the key links for quality improvement and the main causes of follow-up failure, the following intervention measures were adopted: (1) strengthen follow-up publicity and education; (2) build a follow-up team; and (3) establish a follow-up platform and system. The control chart indicated that with the implementation of the above intervention measures, the weekly follow-up rate increased to 74.09% (306/413) in July 2017 and 83.09% (511/615) in December 2017, finally achieving the quality improvement goal. During the COVID-19 pandemic, the follow-up rate of preterm infants fluctuated between 23.54% (460/1 954) and 70.97% (1 931/2 721), and subsequently, it returned to pre-pandemic levels starting in February 2023.
CONCLUSIONS:The application of quality improvement methodology can help to formulate intervention measures based on the main causes of follow-up failure, thereby improving the follow-up rate of preterm infants after discharge. This quality improvement method is feasible and practical and thus holds promise for clinical application.
