Clinical outcomes for newborn intensive care in Alaska.

Recent clinical outcomes for the Newborn Intensive Care Unit (NICU) at Providence Alaska Medical Center based on Alaska Neonatology's Clinical Outcomes Database are presented. There has been a decrease in overall mortality, with much of the improvement occurring in babies from 22 to 25 weeks gestation in the years 1998--2002. There has also been a decrease in the incidence of severe intraventricular hemorrhage / periventricular leukomalacia. Earlier discharge of babies has also been documented, as measured by post conceptual age at discharge. No improvement in the incidence of retinopathy of prematurity and nosocomial sepsis were seen. Rates of chronic lung disease and babies going home in oxygen have increased. Outcomes that have failed to improve are the focus of quality improvement initiatives. Clinical outcome information systems such as the NICU outcomes database are essential for assessing clinical performance and provide the foundation and focus for quality improvement initiatives.