Project seeks to enhance opioid care for infants

The number of opioid-exposed infants who were connected, along with their families, to outside resources upon discharge from the hospital surged in a recent six-month pilot.

The initiative tracked the effect of a checklist designed to streamline and prioritize referrals among an infant’s hospital care team, according to a Vanderbilt University Medical Center study.

Infants exposed to opioids and their families face a variety of obstacles and risks that can impede follow-up care, which is critical for long-term health and well-being.

Team Hope, Vanderbilt’s hospital-wide initiative to improve the care of opioid-exposed infants, sought to standardize a protocol that would bridge infants’ families to outside resources.

Before the checklist was implemented, 2.6% of infants had a fully completed pre-discharge bundle, which includes referrals to a primary care physician; early intervention services; an in-home nursing assessment and educational services; a development clinic if diagnosed with neonatal abstinence syndrome, and the gastroenterology or infectious disease clinic if exposed to hepatitis C virus.

Six months after implementation of the checklist, 60.3% of qualified infants had completed the discharge bundle, according to a study published in a special issue of Hospital Pediatrics focused on newborns diagnosed with drug withdrawal after birth, also known as neonatal abstinence syndrome. The paper is one of three authored by members of the Vanderbilt Center for Child Health Policy in the issue.

“The root of Team Hope’s mission is to change the paradigm from doctors directing care to helping families get what they need to be successful. In six months, we saw marked improvement in how well we were connecting these children to important resources,” said Travis Crook, MD, lead author.

The pilot stemmed from Team Hope’s mission to improve the care of infants and families affected by opioid use by extending the opportunity for good health beyond the hospital walls, said Crook.

Families face a variety of challenges ranging from substance use disorder and transportation to housing — all of which can complicate accessing care.

The focus on completing a discharge checklist for every affected infant — a low-cost intervention — illustrates how coordination between a care team of physicians, social workers, nurses and patient advocates can bridge community resources.

“Nationally, we know there are gaps in connecting families affected by the opioid crisis to services that could help them thrive,” said Stephen Patrick, MD, MPH, MS, director of the Vanderbilt Center for Child Health Policy and senior author.

“At VUMC, we used a simple checklist, coupled with rigorous quality improvement methodology, to do a better job of connecting families to these important community resources. This work is one step forward in our journey to provide better care for our families.”