ILPQC MNO-Neo Monthly Structure Measures Data Collection Form REDCAP Study Identifiers REDCap Record ID REDCap Record ID: _________ Hospital ID Number Hospital ID Number: ________ Please select the time period for this Baseline (October January 2018 – quarterly data: December 2017) February 2018 July 2018 March 2018 August 2018 2018 September 2018 May 2018 October 2018 June 2018 November 2018 July 2018 December 2018 August 2018 September 2018 October 2018 November 2018 December 2018 Hospital has implemented standardized Haven’t started pharmacologic guidelines for opioid-exposed Working on it newborns (OENs) In place Hospital has implemented standardized Haven’t started guidelines for opioid-exposed Working on it newborns (OENs) In place Hospital has implemented standardized started protocols/guidelines for Prenatal Consult, Working on it which includes education for maternal / In place family engagement in care of opioid-exposed newborns (OENs) Hospital has implemented standardized Haven’t started protocols/guidelines for Non-Pharmacologic Working on it Care, includes education for maternal / In place family engagement in care of opioid-exposed newborns (OENs) Hospital has implemented standardized Haven’t started protocols/guidelines for Safe Discharge Working on it Planning, which includes education for In place maternal / family engagement in care of opioid-exposed newborns (OENs)
ILPQC MNO-Neo Monthly Structure Measures Data Collection Form REDCAP Study Identifiers REDCap Record ID REDCap Record ID: _________ Hospital ID Number Hospital ID Number: ________ Please select the time period for this quarterly data: Baseline (October – December 2017) July 2018 August 2018 September 2018 October 2018 November 2018 December 2018 January 2018 February 2018 March 2018 2018 May 2018 June 2018 July 2018 August 2018 September 2018 October 2018 November 2018 December 2018 Hospital has implemented standardized guidelines for opioid-exposed newborns (OENs) Haven’t started Working on it In place Hospital has implemented standardized pharmacologic guidelines for opioid-exposed newborns (OENs) Haven’t started Working on it In place Hospital has implemented standardized protocols/guidelines for Prenatal Consult, which includes education for maternal / family engagement in care of opioid-exposed newborns (OENs) started Working on it In place Hospital has implemented standardized protocols/guidelines for Non-Pharmacologic Care, includes education for maternal / family engagement in care of opioid-exposed newborns (OENs) Haven’t started Working on it In place Hospital has implemented standardized protocols/guidelines for Safe Discharge Planning, which includes education for maternal / family engagement in care of opioid-exposed newborns (OENs) Haven’t started Working on it In place
ILPQC_MNO_Neo_Monthly_Structure_Measures_8.17.2018.docx