Wednesday, August 27, 2014

Caring for the Smallest of our Patients as if Every One was our Loved One

It has been many years since I cared for a sick premature infant, but, I can still remember looking into the eyes of anguished parents while caring for their baby. GBMC is known as a great hospital to have a baby. One of the reasons why this is true is because we have a great Neonatal Intensive Care Unit (NICU).

All health care leaders are proud about the work of their organizations, but my words here are more than bravado.  We can substantiate my claim with facts. Last week, Dr. Howard Birenbaum (pic. rt.), the medical director of our NICU, shared with me the 2013 Vermont Oxford Network (VON) Annual Report. The VON ( is a nonprofit voluntary collaboration of health care professionals established in 1988. Today, the Network is comprised of nearly 1,000 NICUs around the world. The units share data to find the best performers so that they can learn from each other. GBMC’s participation in this network is one measure of our commitment to quality of care.

Some GBMC highlights of the VON report:

- Our mortality for infants 501-1500 grams was 7.4% compared with 12% for the Network.  We have had a declining trend in mortality from 2009-2013.

- Our use of surfactant, a drug to help expand immature lungs, was 27.8% compared with 59.3% in the Network.  We were in the lowest quartile for use since we began using early nasal continuous positive airway pressure (CPAP) and avoiding mechanical ventilation as an approach of minimizing lung injury and chronic lung disease.

- Our use of any mechanical ventilation was 45.3% compared with 59.8% in the Network, also in the lowest quartile.

- Our incidence of chronic lung disease in infants < 33 weeks of gestation (full term is 40 weeks) was 17.8% compared with 25.7% for the Network.

- We had no cases of severe intraventricular (brain) hemorrhage compared with 7.9% for the Network.

- We had 5 cases of late infection (9.4%) compared with 12% for the Network. This trend continues to improve.

- Our incidence of severe retinopathy of prematurity was 2.2% compared with the Network's 5.8%.

- 80% of our babies were discharged feeding human milk versus 55.8% in the Network. We were in the top quartile!

- No infant above 750 grams or 26 weeks gestation was discharged home on oxygen. 

Together with Eva Stone, RN, the NICU nurse manager, Dr. Birenbaum leads a very talented, dedicated, and extremely hard working team of physicians, nurses, respiratory therapists, pharmacists, nursing support technicians, nutritionists, and other technicians, therapists and support personnel. We and our patients and their families are blessed to have such an outstanding team and the data prove it! So when you see any member of this team, please thank them for all that they do in moving us closer to our vision.


  1. As an employee and a patient who had a baby at GBMC last year, I am proud of our hospital and the quality of care provided. Although fortunately my baby did not need the services of the NICU, it is beyond comforting to read about the NICU's success. I continue to spread the word to others in my life who ask about my experience delivering a child at GBMC. The truth is, sometimes it is hard to put my gratitude into words because I am so thankful to my OB, my L&D nurses, my postpartum nurses, the nursery nurses, and of course lactation. Collectively, we have a fantastic team!

  2. Let me give a shout out for the wonderful OB/GYNs, specifically a few who have retired in the past 2-3 years who start start the whole process rolling. Without them, GBMC would not be able to realize these stats. Way to go!


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