EPIQ Results: Reconfiguring Neonatal Care Saves More Preterm Babies from Disability and Death

Who: Dr. Shoo K. Lee, University of Toronto

Issue: Preterm babies are at greater risk of death and disabilities and account for a disproportionately high share of hospitals’ postnatal care costs.

Projects: Dr. Lee began what eventually became EPIQ (Evidence-Based Practice of Improving Quality) in 2002 to reduce rising rates of nosocomial (hospital-acquired) infections and a lung disease called bronchopulmonary dysplasia (BPD). It was followed by a three-year effort to apply EPIQ strategies across Canada and by EPIQ II, which targets additional preterm health threats.

Research Evidence: A randomized controlled trial at 12 Canadian neonatal intensive care units (NICUs) reduced nosocomial infections by 44% and BPD by 15%, a cost savings of almost $2,500 per patient. A study found the improvements in the NICUs were sustained two years afterwards. Early results from EPIQ II indicate reductions in other diseases as well.

Evidence in Action: EPIQ is currently operational in 30 NICUs across Canada, helping to craft and implement continuous quality improvement practices. Internationally, the EPIQ model has been adopted by six Latin American countries, 38 NICUs in Malaysia and is being piloted in China.

Sources: Lee et al. The EPIQ Trial: Reduction in Nosocomial Infection and Bronchopulmonary Dysplasia were Sustained 2 years After the Trial, poster presentation at pediatric academic societies conference 2010.