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Neonatal Outcomes Improvement Project

Nine Interventions

CMS has selected nine interventions, based on available scientific evidence and expert consensus, that States can use to significantly reduce the burden of mortality and morbidity associated with premature birth.

The nine interventions* are:

  1. Identification and treatment of chronic medical conditions (diabetes, hypertension, heart disease, depression, etc.) and high risk behaviors (smoking, substance abuse, domestic violence).
  2. Early identification of mothers at high-risk for prematurity (including those in rural areas) and prenatal transfer of these expectant mothers to facilities with tertiary care Neonatal Intensive Care Units (NICUs).
  3. Use of antenatal steroids in pregnant women at risk of preterm delivery.
  4. For those premature babies born at facilities without tertiary care NICUs, optimal resuscitation and stabilization of the baby before transfer to the appropriate facility.
  5. Prophylactic or early administration of the first dose of surfactant to premature infants at risk for Respiratory Distress Syndrome.
  6. Nutrition Care Bundle in the NICU for infants at-risk for poor growth and bronchopulmonary dysplasia (BPD).
  7. Proper Infection Control Practices in the NICU and hospital to prevent hospital-acquired infection.
  8. Coordinating NICU discharge planning.
  9. Optimizing follow-up care of high-risk infants.

For MORE DETAILS on the nine interventions, check out the Summary of Key Change Concepts for the NICHQ Neonatal Improvement Project. Proposed changes were developed in April 2007 with funding from Centers for Medicare & Medicaid.

*These interventions are an initial draft and are subject to change as the collaborative continues.

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