Judy Aschner, M.D.
Initiative seeks to improve infant mortality rates
A physician at the Monroe Carell Jr. Children's Hospital at Vanderbilt is organizing a statewide effort to improve Tennessee's poor infant mortality/morbidity rates.
Judy Aschner, M.D., director of the Division of Neonatology, says that while infant mortality is a complex social issue, coordinating and improving hospital care of critically ill newborns across the state can help.
“It may be tempting for neonatologists to sit on our laurels and point to the major advances in neonatal care that have allowed more and smaller babies to survive,” Aschner said, “But the fact is there is much we can do if neonatologists work together with the obstetricians, insurers and the Tennessee Department of Health to address access and quality of care for pregnant women and premature infants in Tennessee.”
Aschner is working with colleagues at Vanderbilt and at other hospitals in Nashville and across the state to establish the Tennessee Initiative for Perinatal Quality Care (TIPQC). The organization's first meeting was held in Nashville, Nov. 8-9. More than 100 participants from across the state gathered to learn how other states are tackling this problem and how efforts can be organized to improve the health of mothers and babies in Tennessee.
“With support from the Governor's Office of Children's Care Coordination, we hope to launch initiatives to encourage all neonatal intensive care units (NICUs) across the state to learn from each other and to adopt transparency in practices and outcomes,” Aschner said.
TIPQC will soon begin to collect and compare information about medical services for small and premature infants cared for in Tennessee NICUs. All NICUs in the state will be encouraged to join the Vermont Oxford Neonatal (VON) Network, a voluntary collaboration of providers of neonatal intensive care whose mission is to improve the quality and safety of medical care for newborn infants and their families. About 700 NICUs in the United States and abroad submit their patient data to VON.
Fourteen NICUs in Tennessee currently belong to VON.
“The holy grail of neonatal intensive care is survival without a complication that is likely to result in lifelong disability such as blindness, brain injury or lung injury,” Aschner said. “Our VON report shows we rank in the best quartile among all children's hospitals in VON. Without this kind of comparison data, it is impossible to know if our NICU is delivering the highest quality care or to assess how changes in practice affect the outcomes of our patients. The goal is for all NICUs in the state to join VON and to share data with each other and with the state.”
Tennessee currently ranks 43rd in the nation for infant mortality. The rate of preterm birth in Tennessee increased from 10.8 percent to 12.7 percent between 1994 and 2004. Aschner says part of the mission of TIPQC will be to educate and inform women about prenatal health care and access to the growing number of programs to meet the needs of women of childbearing years, especially those at highest risk for delivering a low birth weight or pre-term baby.