Chronic Lung
Disease
Chronic Lung Disease, also known as Bronchopulmonary Dysplasia, is a lung disease of extreme prematurity. TIPQC has launched this project so that Tennessee’s Tiniest Babies can have the best chance possible in avoiding this problem.
Intro
Chronic Lung Disease, also known as Bronchopulmonary Dysplasia, is a lung disease of extreme prematurity. A preterm baby has very fragile and underdeveloped lungs. Unfortunately, the things done to keep a tiny baby alive can sometimes cause damage to lungs. There are, however, potentially better practices, that can be implemented that can decrease the risk of this happening. TIPQC has launched this project so that Tennessee’s Tiniest Babies can have the best chance possible in avoiding this problem.
The TIPQC Prevention of Chronic Lung Disease (CLD) Improvement Project is the second project under the Tennessee Tiniest Babies Bundle with the project aim of a 25% relative reduction (over last 3 years institutional baseline) in chronic lung disease and a 10% relative reduction in Grade 3 Bronchopulmonary dysplasia (BPD) in infants less than or equal to 29.6 weeks gestational age in participating TN NICUs by June 2025. This project is open to all level 3 and 4 NICUs across the state who care for infants <32 weeks and a birth weight <1500g.
While advances in neonatal care have significantly improved ELBW survival, BPD rates have not improved. Multiple factors contribute to CLD including mechanical ventilation, oxygen toxicity, infection, inflammation, and preventing secondary lung injury. Collectively, improvements in these areas can reduce morbidity and mortality in preterm infants. Quality improvement (QI) projects focused on the implementation of potentially better practices have demonstrated that single institutions and even collaborative efforts can decrease the incidence of CLD.
In 2020, 1,352 babies, or 1.7% of live births, were born very preterm in Tennessee and cared for at these facilities. Statistically, this group of infants represents approximately one-third of our state’s infant deaths which include disparities amongst racial and ethnic groups. To lower Tennessee’s infant mortality rate, meet the goal as put forth in the “2030 Healthy People” objectives, and improve equity by reducing disparities in care, a collaborative approach to the care along with the implementation of effective care strategies will be realized through this bundle.
TIPQC is proud to have teams of healthcare professionals and parents participate in this very important project. This project, like so many of the other TIPQC projects, is aimed at improving care for babies and families one project at a time.
Project
Application
The following application components must be completed before your project team will be approved to participate in this inter-institutional QI project:
Please note that execution of the TIPQC Participation and Data Use Agreement (DUA) with TIPQC is required prior to approval of your facility for this project application. Many facilities have already completed this step. It is only required once and is applicable to all projects.
It is recommended that the “day to day” project team member (i.e. key contact person) complete this application.
- East Tennessee Children’s Hospital*
- Jackson-Madison County General Hospital*
- Regional One Health*
- Niswonger Children’s Hospital*
- Methodist Le Bonheur Germantown
- University of Tennessee Medical Center, Knoxville
- Parkridge East Hospital
- Baptist Memorial Hospital for Women
- Monroe Carell Jr Children’s Hospital at Vanderbilt
- TriStar Centennial Medical Center
*Denotes Pilot Hospital
State Project Leaders
Malinda Harris, MD a neonatologist at East Tennessee Children’s Hospital, Vineet Lamba, MD a neonatologist at Regional One Health and Assistant Professor, Department of Pediatrics, Division of Neonatology, The University of Tennessee Health Science Center, and Marla Kirk, MBA, BS, RRT from Methodist Bonheur Germantown along with the TTB Statewide Leader, Scott Guthrie, MD, neonatologist, Vanderbilt University Medical Center and Jackson Madison County General Hospital and TIPQC Infant Medical Director from 2021-23 are the state champions of this project.