One of the leading indicators for term infant transfer is suspected HIE. We recently found that newborns who could benefit from prompt referral in Iowa for HIE are not always being identified for cooling therapy in a standardized fashion. When these newborns are identified, we determined that the median time from birth to definitive cooling exceeded the best practice of six hours, especially in outborn infants based on data collected over an 18-month period from a single cooling center.

To improve care for newborns and families affected by HIE we are embarking on a statewide quality improvement initiative focused on addressing the processes around initialscreening, serial assessment, and referral for therapeutic hypothermia (or NICU admission at a cooling center) for newborns that may qualify for this lifesaving and neuroprotective therapy. If barriers to providing evidence-based practices exist, the initiative will help us identify potential solutions to address them. The effort is funded by the Centers for Disease Control and Prevention in their goal of supporting new and existing Statewide Perinatal Quality Collaboratives (PQCs).