PT - JOURNAL ARTICLE AU - Shoo K. Lee AU - Khalid Aziz AU - Nalini Singhal AU - Catherine M. Cronin AU - Andrew James AU - David S.C. Lee AU - Derek Matthew AU - Arne Ohlsson AU - Koravangattu Sankaran AU - Mary Seshia AU - Anne Synnes AU - Robin Walker AU - Robin Whyte AU - Joanne Langley AU - Ying C. MacNab AU - Bonnie Stevens AU - Peter von Dadelszen TI - Improving the quality of care for infants: a cluster randomized controlled trial AID - 10.1503/cmaj.081727 DP - 2009 Oct 13 TA - Canadian Medical Association Journal PG - 469--476 VI - 181 IP - 8 4099 - http://www.cmaj.ca/content/181/8/469.short 4100 - http://www.cmaj.ca/content/181/8/469.full SO - CMAJ2009 Oct 13; 181 AB - Background: We developed and tested a new method, called the Evidence-based Practice for Improving Quality method, for continuous quality improvement. Methods: We used cluster randomization to assign 6 neonatal intensive care units (ICUs) to reduce nosocomial infection (infection group) and 6 ICUs to reduce bronchopulmonary dysplasia (pulmonary group). We included all infants born at 32 or fewer weeks gestation. We collected baseline data for 1 year. Practice change interventions were implemented using rapid-change cycles for 2 years. Results: The difference in incidence trends (slopes of trend lines) between the ICUs in the infection and pulmonary groups was − 0.0020 (95% confidence interval [CI] − 0.0007 to 0.0004) for nosocomial infection and − 0.0006 (95% CI − 0.0011 to − 0.0001) for bronchopulmonary dysplasia. Interpretation: The results suggest that the Evidence-based Practice for Improving Quality method reduced bronchopulmonary dysplasia in the neonatal ICU and that it may reduce nosocomial infection.