Newborn Specialized Transport Madrid (SUMMA 112), Neonatology Department, Gregorio Marañón Hospital, O'Donnell 48 Street, 28009, Madrid, Spain.
Newborn Specialized Transport Madrid (SUMMA 112), Neonatology Department, Hospital Universitario La Paz, Madrid, Spain.
Eur J Pediatr. 2020 Jun;179(6):919-928. doi: 10.1007/s00431-020-03573-z. Epub 2020 Jan 28.
There is a lack of consensus on quality indicators suitable for neonatal transport. The aim of this study is to make a proposal for specific quality indicators for newborn transport. A retrospective descriptive study was performed (2009 to 2015) where twenty-four indicators were selected, evaluated and classified according to the 6 dimensions of quality of the Institute of Medicine. Among the 24 evaluated quality metrics, there were 3 of them which needed a correction when evaluating neonatal transport performance, because they were significantly correlated with gestational age. They were (a) stabilisation time, (b) prevalence of newborn arterial hypotension (defined by gestational age) and (c) unnoticed hypothermia at referral hospital.Conclusion: Quality evaluation through the definition of specific metrics in newborn transport is feasible. These indicators should be defined or adjusted for newborn population to measure the actual performance of the transport service.What is Known:• Quality indicators may help in defining metrics for clinical practice, promoting benchmarking and defining areas of improvement.• Newborn characteristics call for a specialised care, and quality measure during newborn transport require specific metrics. Quality metrics for paediatric transport have been defined using Delphi method. Some of these measures need to be specific for newborn, due to their intrinsic characteristics.What is New:• Using evidence-based literature and our newborn transport experience, specific quality indicators for newborn transport are suggested.• Data analysis shows how some indicators need to be adjusted for gestational age.
目前，针对新生儿转运质量指标尚未达成共识。本研究旨在为新生儿转运提出具体的质量指标建议。本研究采用回顾性描述性研究方法（2009 年至 2015 年），选取了 24 项指标，并根据美国医学研究所的 6 个维度对其进行评估和分类。在评估的 24 项质量指标中，有 3 项指标需要在评估新生儿转运表现时进行修正，因为它们与胎龄显著相关，这 3 项指标是：（a）稳定时间，（b）新生儿动脉低血压的发生率（根据胎龄定义），（c）转运至接诊医院时未被察觉的低体温。结论：通过定义新生儿转运的具体指标来进行质量评估是可行的。这些指标应针对新生儿人群进行定义或调整，以衡量转运服务的实际表现。已知：•质量指标有助于定义临床实践的指标，促进基准测试和确定改进领域。•新生儿的特点需要特殊护理，新生儿转运的质量衡量需要特定的指标。已经使用 Delphi 方法定义了儿科转运的质量指标。由于其内在特征，其中一些措施需要针对新生儿进行具体调整。新内容：•利用循证文献和我们的新生儿转运经验，提出了新生儿转运的具体质量指标。•数据分析表明，一些指标需要根据胎龄进行调整。
