Abstract
Compare Eat, Sleep, Console (ESC) and limited opioid treatment on birth length of stay (LOS), postnatal opioid exposure, and 30-day re-hospitalizations in opioid-exposed newborns (OENs) in two hospital systems. Quality improvement teams supported change from scheduled methadone using Finnegan scores to standardized non-pharmacologic support using ESC. Intermittent morphine was used only if needed. Statistical process control charts examined changes over time. Between 2017 and 2019 we treated 280 OENs ≥35 weeks' gestation, 101 and 179 per hospital. Post-ESC, LOS decreased 51.2% (16.8-8.2 days), postnatal opioid treatment decreased from 64.1 to 29.9%; percent decline in both hospitals was similar. 30-day re-hospitalizations were 5/103 (4.8%) pre-ESC, and 7/177 (4.0%) post-ESC (p = 0.72, NS). Multiple substance co-exposures were common (226/280, 80.7%). ESC and as needed morphine decreased LOS and postnatal opioid exposure for OENs in two hospital systems without increasing 30-day readmissions. ESC appears effective in OENs with multiple co-exposures.
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