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Objective <p>Using the 2022 NICHD BPD risk estimator (BPDe2022) to improve timely identification of extremely preterm neonates at risk for bronchopulmonary dysplasia (BPD) and to optimize appropriate systemic corticosteroid (SC) therapy.</p> Study design <p>Quality Improvement initiative across three NICUs within Johns Hopkins Health System. Plan-Do-Study-Act (PDSA) cycles focused on EMR integration, documentation, and provider education on risk estimation and SC use. Included neonates born ≤28 6/7 weeks GA or ≤1000 g BW. Outcome, process, and balancing measures were tracked from April 2024 through April 2025.</p> Results <p>BPD risk assessment documentation increased from 2% to 80%, and appropriate SC prescribing from 50% to 88%, temporally associated with intervention implementation. Mortality before 36 weeks PMA decreased from 19% to 4% (<i>p</i> &lt; 0.001).</p> Conclusion <p>Multi-NICU QI initiative successfully integrated the 2022 NICHD BPD risk estimator into clinical workflows, improving timely risk assessment and adherence to evidence-based corticosteroid prescribing and stewardship.</p>

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“Right baby, right time: a multi-NICU quality improvement initiative using the 2022 NICHD BPD risk estimator to guide timely steroid therapy”

  • 期刊论文

  • 发表日期：

    2026年7月6日

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  • A. Martinez,
  • A. Germain,
  • O. Winners,
  • F. Shakeel,
  • K. Makker,
  • S. Desiraju,
  • M. M. Gilmore,
  • M. Gontasz,
  • S. Atteih,
  • J. Fierstein,
  • J. Machry

摘要

Objective

Using the 2022 NICHD BPD risk estimator (BPDe2022) to improve timely identification of extremely preterm neonates at risk for bronchopulmonary dysplasia (BPD) and to optimize appropriate systemic corticosteroid (SC) therapy.

Study design

Quality Improvement initiative across three NICUs within Johns Hopkins Health System. Plan-Do-Study-Act (PDSA) cycles focused on EMR integration, documentation, and provider education on risk estimation and SC use. Included neonates born ≤28 6/7 weeks GA or ≤1000 g BW. Outcome, process, and balancing measures were tracked from April 2024 through April 2025.

Results

BPD risk assessment documentation increased from 2% to 80%, and appropriate SC prescribing from 50% to 88%, temporally associated with intervention implementation. Mortality before 36 weeks PMA decreased from 19% to 4% (p < 0.001).

Conclusion

Multi-NICU QI initiative successfully integrated the 2022 NICHD BPD risk estimator into clinical workflows, improving timely risk assessment and adherence to evidence-based corticosteroid prescribing and stewardship.