Vermont Oxford Network - International Benchmarking

The Vermont Oxford Network (VON) is a non-profit, global voluntary collaboration of health care workers dedicated to improving quality and outcomes in neonatal care. The aim is to improve the quality and safety of medical care for newborn infants and their families through coordinated programme of education and quality improvement projects. It does this by maintaining 2 databases that contain information about the care and outcomes of high risk newborn infants. To date, there are nearly 1000 Neonatal Intensive Care Units in the network from hospitals around the world. The VON databases hold critical information on more than 1.5 million infants.

The KK Women’s and Children’s Hospital Department of Neonatology has been part of the Vermont Oxford Network since 1998. We participate in both databases. The Very Low Birth Weight (VLBW database) include data from all live born infants where birth weight is between 401 grams and 1500 grams or where gestational age is between 22 weeks till 29 weeks and 6 days who are admitted to our unit within 28days of birth without having first gone home. In 2012, 909 centers submitted data on 60, 007 VLBW infants.

The Expanded Database includes all infants over 401 grams at birth who are admitted to our NICU. These children are followed up till discharge. In 2012, 369 centers completed data submission for the Expanded Database. These centers admitted 153,093 infants.

We also participate in the Vermont Oxford Network Extremely Low Birth Weight (ELBW) Infant Follow-Up Project that assesses the health and neurodeveopmental status at 18 to 24 months corrected age of infants born weighing 1000 grams or less, or between 22 and 28 weeks gestational age, who survived until hospital discharge. We benchmark their outcomes with the Vermont Oxford Network follow-up cohort.

The Vermont Oxford Network serves as a neutral, independent party in analyzing data for our member centers and facilitating voluntary benchmarking activities. The databases are used to provide comprehensive, confidential reports that serve as a critical foundation for local quality improvement projects for participating centers.

Our aim is to be within the best quartile for all Key Performance Measures (see Table 1). We institute quality improvement initiatives when we review that we are not within the best quartile as compared to similar NICUs in the network.

For the year 2013, we were in the best quartile for Death or Morbidity, Chronic Lung Disease, Fungal Infection and Severe Intraventricular Haemorrhage (IVH). We also trend our performance (see Charts 1 and 2).