The International Network for Evaluating Outcomes of very low birth weight, very preterm neonates (iNeo): a protocol for collaborative comparisons of international health services for quality improvement in neonatal care

Abstract

BackgroundThe International Network for Evaluating Outcomes in Neonates (iNeo) is a collaboration of population-based national neonatal networks including Australia and New Zealand, Canada, Israel, Japan, Spain, Sweden, Switzerland, and the UK. The aim of iNeo is to provide a platform for comparative evaluation of outcomes of very preterm and very low birth weight neonates at the national, site, and individual level to generate evidence for improvement of outcomes in these infants.Methods/designIndividual-level data from each iNeo network will be used for comparative analysis of neonatal outcomes between networks. Variations in outcomes will be identified and disseminated to generate hypotheses regarding factors impacting outcome variation. Detailed information on physical and environmental factors, human and resource factors, and processes of care will be collected from network sites, and tested for association with neonatal outcomes. Subsequently, changes in identified practices that may influence the variations in outcomes will be implemented and evaluated using quality improvement methods.DiscussionThe evidence obtained using the iNeo platform will enable clinical teams from member networks to identify, implement, and evaluate practice and service provision changes aimed at improving the care and outcomes of very low birth weight and very preterm infants within their respective countries. The knowledge generated will be available worldwide with a likely global impact.

Outborns or Inborns: Where Are the Differences? A Comparison Study of Very Preterm Neonatal Intensive Care Unit Infants Cared for in Australia and New Zealand and in Canada

“…However, the study has helped clarify important processes of dealing with ethical issues and confidentiality for international data transfer and governance, and with reaching consensus on definitions for outcome comparison and understanding the operational differences in regionalization. This collaborative work between ANZNN and CNN has since progressed to further international collaboration [29]. …”

Respiratory Management of Extremely Preterm Infants: An International Survey

“…All participating networks obtained ethics/regulatory approval or the equivalent from their local granting agencies as part of the protocol for collaborative comparisons of international health services for quality improvement in neonatal care [11]. Specific approval for this project was obtained from the Research Ethics Board at Mount Sinai Hospital, Toronto (ON, Canada) where the coordination of the project was conducted.…”

“…The International Network for Evaluating Outcomes (iNeo) of Neonates is a multinational collaboration of population-based national neonatal networks including 11 countries and aims to provide a platform for comparative evaluation of outcomes of extremely preterm infants and very low birth weight infants at the national, site, and individual level to improve outcomes of these infants. The structure, design, and overall objectives of the iNeo collaboration have been previously described [11]. In this study, our objective was to survey and compare the variations in clinical practices for the management of respiratory conditions in extremely preterm infants born at < 29 weeks’ GA among 10 neonatal networks participating in iNeo.…”

eNewborn: The Information Technology Revolution and Challenges for Neonatal Networks

“…In a recent review, Shah et al [12] described successful results from the major networks in North America, including the open Vermont Oxford Network (VON), the academic selective membership National Institutes of Child Health and Human Development Neonatal Research Network (NICHD-NRN), corporate health care provider networks, regional networks, the Canadian Neonatal Network (CNN), and the Australia-New Zealand Neonatal Network (ANZNN). The international network for evaluating outcomes of very low birth weight, very preterm neonates (iNeo) is a population-based collaboration bringing together data from several national neonatal networks, such as ANZNN, CNN, Israeli Neonatal Network (INN), Neonatal Research Network of Japan (NRNJ), Spanish Neonatal Network (SEN1500), Swedish Neonatal Quality Register (SNQ), Swiss Neonatal Network (SNN), and the UK Neonatal Collaborative (UKNC) [13]. The iNeo collaboration is making international comparisons and has underlined the importance of the critical interpretation of findings.…”