Less Invasive Surfactant Administration

Implementation of this quality project increased compliance levels of LISA (16 infants pre-project, 43 infants post-project) in place of INSURE (16 infants pre-project, 4 post-project) from 47% to a consistent 100% for eligible infants by 2 months after the project implementation. It also improved multiple outcome measures for the LISA procedure, including a reduction of grade III and IV intraventricular hemorrhage (IVH), a decrease in the percentage of infants requiring a second surfactant dose, and a decrease in chronic lung disease (CLD). LISA was expanded to other hospitals in the physician group's network.