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Intraventricular

Hemorrhage

Focused on reducing the incidence of severe intraventricular hemorrhage (sIVH) in Tennessee’s tiniest babies.

Intro

The first project in the Tennessee Tiniest Baby Bundle is the prevention of severe intraventricular hemorrhage (sIVH).  Intraventricular hemorrhage is bleeding inside or around the ventricles of the brain.  Severe IVH is defined as a Grade III or IV hemorrhage and is considered one of the most concerning complications of preterm birth.  Level III and IV NICUs from across Tennessee have come together to achieve a 25% relative reduction (from the respective facility’s baseline over the past 3 years) in sIVH in this population by March of 2024.  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.


Tennessee NICUs Join Together to Improve Care for the Tiniest Babies

The Tennessee Initiative for Perinatal Quality Care (TIPQC) just completed the state Severe Intraventricular Hemorrhage (sIVH) Project, improving the outcomes of infants born less than or equal to 29.6 weeks gestational age. 

During the project, which began December 2022 and moved to sustainment June 2024, all the Level Ill and IV Neonatal Intensive Care Units (NICUs) from across Tennessee worked to achieve a 25% relative reduction (facility’s previous 3-year baseline) in slVH in this population, as well as an overall 25% reduction in mortality.

Two (2) hospitals achieved a Platinum QI rating which consisted of active project participation including huddles and coaching calls, monthly outcome and structure data capture, data driven QI work, clinical change implementation, and decreasing the rates of sIVH as well as decreasing mortality:

  • University of Tennessee Medical Center, Knoxville
  • Methodist LeBonheur Germantown Hospital

Five (5) hospitals received a Gold QI Rating, having achieved 5 out of 7 of the above criteria, which included:

  • Baptist Memorial Hospital
  • East Tennessee Children’s Hospital
  • Jackson Madison County General Hospital
  • Monroe Carell Jr. Children’s Hospital
  • Parkridge East Hospital

All hospitals improved care to reduce sIVH. Congratulations to all the teams!

 

QI Project

Guidance & Resources

QI Project Guidance

Resources for Teams

Login required.

QI Project Guidance

IVH Key Driver Diagram

This diagram provides an overview of primary and secondary drivers with interventions.

QI Project Guidance

IVH Tool Kit

Overall project kit to support your efforts.

QI Project Guidance

TTB-sIVH Data Entry Form

This clinical care checklist provides guidance and data to collect for infants born at <=29.6 weeks of gestation.

QI Project Guidance

IVH Key Driver Summary Diagram

This version of the Driver Diagram provides a more specific and summarized version of the drivers and interventions.

Resources

IVH State IRB Approval

Review Determination from State of Tennessee Institutional Review Board.

Resources

IVH Protocol

This protocol provides the description for the collaborative framework for this project (for use with your IRB, if needed).

Video

Infomercial

If you missed it, you can still stream it.

Resources

Additional IVH Information

Please note: To access these resources, you must have a login. 

Video

Resources

Teams

  • Baptist Memorial Hospital for Women
  • East Tennessee Children’s Hospital *
  • Erlanger Health System
  • Jackson-Madison County General Hospital *
  • Methodist LeBonheur Germantown Hospital
  • Monroe Carell Jr Children’s Hospital at Vanderbilt
  • Niswonger Children’s Hospital
  • Parkridge East
  • Regional One Health *
  • St. Thomas Midtown
  • TriStar Centennial Medical Center *
  • University of Tennessee Medical Center Knoxville *

State Project Leaders

Parul Zaveri, MD is a neonatologist at Regional One Medical Center and Assistant Professor, University of Tennessee Health Science Center.

Marcelo Rains, MD is a neonatologist at Erlanger Health System and an

Get

Involved.


TIPQC is actively recruiting devoted health care professionals, community leaders and patient and family partners to further our mission of improving health outcomes for mothers and babies in Tennessee.