Composite Metrics to Assess Quality Improvement in Very Low Birth Weight Infants: 2010–2023

The Benefit Metric proficiency score from 16 affiliated NICUs showed no progress 2010 to 2023. The Value Metric efficiency score declined because survivor length of stay increased. To improve mortality, morbidity rates, and cost proxies of resource expenditure will require scalable potentially better practices, robust adherence measurements of evidence-based structures and processes, identification of influential culture/environment factors, extensive shared experience, and development of more comprehensive risk-adjustment methodologies that enhance accurate, meaningful NICU comparisons.