A model for quality improvement in the neonatal intensive care unit.

This article describes a global approach for improving care in the neonatal intensive care unit, using as a case study the process to decrease mortality in extremely low-birth-weight neonates at Lee Memorial Health System, The Children's Hospital of Southwest Florida. Key components to the development of an integrated quality improvement (QI) program--information systems, use of evidence-based medicine, and organizational structure and culture--are presented. The challenge of demonstrating true improvement and the need to better understand the cost of care associated with QI initiatives also are discussed.