Successful Implementation of the Eat Sleep Console Model of Care for Infants With NAS in a Community Hospital.

Abstract

Opioid use across the United States is increasing. The concomitant rise in the incidence of neonatal abstinence syndrome (NAS) has made care of infants with this disease process a top priority for pediatric centers across the country. There is growing evidence that the Eat Sleep Console (ESC) model of care is superior to the established Finnegan Neonatal Abstinence Scoring System model. We aimed to improve the care of infants with NAS by transitioning from the Finnegan Neonatal Abstinence Scoring System model to the ESC model of care. Our goal was to decrease the average length of stay from 11.77 to 5.94 days without having an increase in readmissions. A multidisciplinary team was created. Education about NAS and ESC was created and distributed. Patients were admitted to the inpatient unit, and outcomes were observed. Standard quality improvement methodology was used for this intervention. After implementation of the ESC care model, average length of stay decreased to 5.94 days, with 0 patients readmitted or transferred for NAS-related complications. We saw a 48% reduction in average variable cost per patient. In addition to these reductions and savings, total per patient morphine exposure was reduced from 2.25 to 0.45 mg/kg, a 79% reduction in use. The ESC model of care was successfully implemented at our institution with resultant cost savings, decreased length of stay, and decreased medication use. Our work further supports the adoption of this new model of care for infants with NAS.