Telemedicine and Quality Improvement as Strategies for Extending Intensive Care Services to Neonates

The goal of a study was to assess the impact of hybrid support (tele-mentoring and conventional support) on adverse outcomes among neonates in 10 special newborn care units (SNCUs) in Chhattisgarh.

This study included 10 SNCUs before and after their completion in 2022. Initially, conventional support was provided, which was then supplemented with tele-rounds via Skype. The principal investigator (PI) visited each unit monthly to initiate quality improvement (QI) projects and provide guidance. Data on clinical sepsis, IV fluid usage, antibiotic usage, length of stay, referrals, and mortality were collected.

Overall, 2,807 babies were assessed and compared to 5,169 babies from the previous year. The percentage of clinical neonatal sepsis cases decreased from 53.4% to 29.4%. IV fluid usage dropped from 40% to 22.2%. Additionally, the initiation and continuation of kangaroo mother care (KMC) increased from 55.5% to 93.8%. The average length of stay decreased from 5.5 ± 0.97 days to 4 ± 0.2 days. Oxygen utilization decreased from 39.3% to 33.6%. Antibiotic usage decreased from 50.2% to 39.7%. Further, the mortality rate dropped from 8.18% to 6.99%, and referral rates decreased from 13.12% to 11.93%.

Hence, implementing a QI package through hybrid support, including tele-mentoring, supportive supervision visits, and local QI project advocacy, effectively enhances newborn intensive care.

Source: Agarwal N, Anand R, Jindal A, et al. Indian Journal of Pediatrics. 2024 Jul 15:1-7.