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The Korean Neonatal Network: An Overview.

Chang YS, Park HY, Park WS - J. Korean Med. Sci. (2015)

Bottom Line: About 2,000 VLBWIs from 60 participating hospital NICUs are registered annually in the KNN.The KNN has built unique systems such as a web-based real-time data display on the web site and a site-visit monitoring system for data quality surveillance.The KNN should be maintained and developed further in order to generate appropriate, population-based, data-driven, health-care policies; facilitate active multicenter neonatal research, including quality improvement of neonatal care; and ultimately lead to improvement in the prognosis of high-risk newborns and subsequent reduction in health-care costs through the development of evidence-based neonatal medicine in Korea.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT
Currently, in the Republic of Korea, despite the very-low-birth rate, the birth rate and number of preterm infants are markedly increasing. Neonatal deaths and major complications mostly occur in premature infants, especially very-low-birth-weight infants (VLBWIs). VLBWIs weigh less than 1,500 g at birth and require intensive treatment in a neonatal intensive care unit (NICU). The operation of the Korean Neonatal Network (KNN) officially started on April 15, 2013, by the Korean Society of Neonatology with support from the Korea Centers for Disease Control and Prevention. The KNN is a national multicenter neonatal network based on a prospective web-based registry for VLBWIs. About 2,000 VLBWIs from 60 participating hospital NICUs are registered annually in the KNN. The KNN has built unique systems such as a web-based real-time data display on the web site and a site-visit monitoring system for data quality surveillance. The KNN should be maintained and developed further in order to generate appropriate, population-based, data-driven, health-care policies; facilitate active multicenter neonatal research, including quality improvement of neonatal care; and ultimately lead to improvement in the prognosis of high-risk newborns and subsequent reduction in health-care costs through the development of evidence-based neonatal medicine in Korea.

No MeSH data available.


Related in: MedlinePlus

Diagram of the participation process in the Korean Neonatal Network (KNN). When the principal investigator (PI) in a certain hospital applies to participate in the KNN, the PI has to sign the pledge first for fulfilling the obligations and commitments, keeping the information secure during KNN participation. Then, the PI has to obtain IRB approval for the KNN registry from his/her hospital and required official education for the use of the iCReaT. When the PI submit IRB approval document to the KNN, the iCReat ID that enables access to the KNN Web-based registry was provided. After receiving the KNN participation certificate plate, the institution can start the KNN registry. To view their own real-time data display on the secure KNN member Web site, PIs have to confirm the entered data to the KNN e-CRF and resolve the auto and manual queries sent from the KNN center periodically. In addition, the PI has to accept the KNN site-visit monitoring twice a year for quality surveillance of data and the KNN administrative process. Accumulated data are locked periodically, followed by cleaning and statistical analysis by central data managers. Then, the KNN executive committee publishes a total or individual annual report of the previous year. It provides powerful interactive data-driven evidence for quality improvement to the individual participating center. Academic studies that used the KNN data are promoted through the study proposal application system. Active collaborations among participants occur directly in the education or PI seminar once a year and indirectly but continuously through the KNN Web site. PI, principal investigator; IRB, institutional review board; iCReaT, internet-based clinical research and trial; ID, identification.
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Figure 4: Diagram of the participation process in the Korean Neonatal Network (KNN). When the principal investigator (PI) in a certain hospital applies to participate in the KNN, the PI has to sign the pledge first for fulfilling the obligations and commitments, keeping the information secure during KNN participation. Then, the PI has to obtain IRB approval for the KNN registry from his/her hospital and required official education for the use of the iCReaT. When the PI submit IRB approval document to the KNN, the iCReat ID that enables access to the KNN Web-based registry was provided. After receiving the KNN participation certificate plate, the institution can start the KNN registry. To view their own real-time data display on the secure KNN member Web site, PIs have to confirm the entered data to the KNN e-CRF and resolve the auto and manual queries sent from the KNN center periodically. In addition, the PI has to accept the KNN site-visit monitoring twice a year for quality surveillance of data and the KNN administrative process. Accumulated data are locked periodically, followed by cleaning and statistical analysis by central data managers. Then, the KNN executive committee publishes a total or individual annual report of the previous year. It provides powerful interactive data-driven evidence for quality improvement to the individual participating center. Academic studies that used the KNN data are promoted through the study proposal application system. Active collaborations among participants occur directly in the education or PI seminar once a year and indirectly but continuously through the KNN Web site. PI, principal investigator; IRB, institutional review board; iCReaT, internet-based clinical research and trial; ID, identification.

Mentions: Following the application and participation to the KNN (Fig. 4), the KNN member institutions receive objective feedback with data-driven comparisons of the current statuses of their NICUs with that of the overall status of the KNN participating NICUs. They can do this by themselves by using the real-time display at the KNN Website at any time. Furthermore, the KNN executive committee publishes an annual report by using the data for the total registered cases born in the previous year, thus already locked and cleared through the data management process. Each annual report contains a summary of all of the e-CRF items analyzed according to 1-week gestational age and 100-g birth weight of the enrolled infants. Moreover, the KNN executive committee sends individual and confidential annual reports to each PI in each institution. The report contains a comparison of important items from e-CRF between those from all the participating hospitals and those from individual hospitals, along with a summary according to 1-week gestational age and 100-g birth weight of the enrolled infants. In addition, it contains the position of each institution among all the KNN participating hospitals for each category while showing the relative position in 25-75 percentile graphics or calculated odds ratio (OR) adjusted by gestational age of the enrolled VLBWIs (Fig. 5). These can provide objective evidence of the status of an NICU in relation to all the NICUs participating in the KNN, in terms of patient characteristics, treatment policies, care quality, and patient outcomes. Therefore, it provides powerful evidence-based feedback to promote quality improvement in each participating NICU eventually.


The Korean Neonatal Network: An Overview.

Chang YS, Park HY, Park WS - J. Korean Med. Sci. (2015)

Diagram of the participation process in the Korean Neonatal Network (KNN). When the principal investigator (PI) in a certain hospital applies to participate in the KNN, the PI has to sign the pledge first for fulfilling the obligations and commitments, keeping the information secure during KNN participation. Then, the PI has to obtain IRB approval for the KNN registry from his/her hospital and required official education for the use of the iCReaT. When the PI submit IRB approval document to the KNN, the iCReat ID that enables access to the KNN Web-based registry was provided. After receiving the KNN participation certificate plate, the institution can start the KNN registry. To view their own real-time data display on the secure KNN member Web site, PIs have to confirm the entered data to the KNN e-CRF and resolve the auto and manual queries sent from the KNN center periodically. In addition, the PI has to accept the KNN site-visit monitoring twice a year for quality surveillance of data and the KNN administrative process. Accumulated data are locked periodically, followed by cleaning and statistical analysis by central data managers. Then, the KNN executive committee publishes a total or individual annual report of the previous year. It provides powerful interactive data-driven evidence for quality improvement to the individual participating center. Academic studies that used the KNN data are promoted through the study proposal application system. Active collaborations among participants occur directly in the education or PI seminar once a year and indirectly but continuously through the KNN Web site. PI, principal investigator; IRB, institutional review board; iCReaT, internet-based clinical research and trial; ID, identification.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4641061&req=5

Figure 4: Diagram of the participation process in the Korean Neonatal Network (KNN). When the principal investigator (PI) in a certain hospital applies to participate in the KNN, the PI has to sign the pledge first for fulfilling the obligations and commitments, keeping the information secure during KNN participation. Then, the PI has to obtain IRB approval for the KNN registry from his/her hospital and required official education for the use of the iCReaT. When the PI submit IRB approval document to the KNN, the iCReat ID that enables access to the KNN Web-based registry was provided. After receiving the KNN participation certificate plate, the institution can start the KNN registry. To view their own real-time data display on the secure KNN member Web site, PIs have to confirm the entered data to the KNN e-CRF and resolve the auto and manual queries sent from the KNN center periodically. In addition, the PI has to accept the KNN site-visit monitoring twice a year for quality surveillance of data and the KNN administrative process. Accumulated data are locked periodically, followed by cleaning and statistical analysis by central data managers. Then, the KNN executive committee publishes a total or individual annual report of the previous year. It provides powerful interactive data-driven evidence for quality improvement to the individual participating center. Academic studies that used the KNN data are promoted through the study proposal application system. Active collaborations among participants occur directly in the education or PI seminar once a year and indirectly but continuously through the KNN Web site. PI, principal investigator; IRB, institutional review board; iCReaT, internet-based clinical research and trial; ID, identification.
Mentions: Following the application and participation to the KNN (Fig. 4), the KNN member institutions receive objective feedback with data-driven comparisons of the current statuses of their NICUs with that of the overall status of the KNN participating NICUs. They can do this by themselves by using the real-time display at the KNN Website at any time. Furthermore, the KNN executive committee publishes an annual report by using the data for the total registered cases born in the previous year, thus already locked and cleared through the data management process. Each annual report contains a summary of all of the e-CRF items analyzed according to 1-week gestational age and 100-g birth weight of the enrolled infants. Moreover, the KNN executive committee sends individual and confidential annual reports to each PI in each institution. The report contains a comparison of important items from e-CRF between those from all the participating hospitals and those from individual hospitals, along with a summary according to 1-week gestational age and 100-g birth weight of the enrolled infants. In addition, it contains the position of each institution among all the KNN participating hospitals for each category while showing the relative position in 25-75 percentile graphics or calculated odds ratio (OR) adjusted by gestational age of the enrolled VLBWIs (Fig. 5). These can provide objective evidence of the status of an NICU in relation to all the NICUs participating in the KNN, in terms of patient characteristics, treatment policies, care quality, and patient outcomes. Therefore, it provides powerful evidence-based feedback to promote quality improvement in each participating NICU eventually.

Bottom Line: About 2,000 VLBWIs from 60 participating hospital NICUs are registered annually in the KNN.The KNN has built unique systems such as a web-based real-time data display on the web site and a site-visit monitoring system for data quality surveillance.The KNN should be maintained and developed further in order to generate appropriate, population-based, data-driven, health-care policies; facilitate active multicenter neonatal research, including quality improvement of neonatal care; and ultimately lead to improvement in the prognosis of high-risk newborns and subsequent reduction in health-care costs through the development of evidence-based neonatal medicine in Korea.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT
Currently, in the Republic of Korea, despite the very-low-birth rate, the birth rate and number of preterm infants are markedly increasing. Neonatal deaths and major complications mostly occur in premature infants, especially very-low-birth-weight infants (VLBWIs). VLBWIs weigh less than 1,500 g at birth and require intensive treatment in a neonatal intensive care unit (NICU). The operation of the Korean Neonatal Network (KNN) officially started on April 15, 2013, by the Korean Society of Neonatology with support from the Korea Centers for Disease Control and Prevention. The KNN is a national multicenter neonatal network based on a prospective web-based registry for VLBWIs. About 2,000 VLBWIs from 60 participating hospital NICUs are registered annually in the KNN. The KNN has built unique systems such as a web-based real-time data display on the web site and a site-visit monitoring system for data quality surveillance. The KNN should be maintained and developed further in order to generate appropriate, population-based, data-driven, health-care policies; facilitate active multicenter neonatal research, including quality improvement of neonatal care; and ultimately lead to improvement in the prognosis of high-risk newborns and subsequent reduction in health-care costs through the development of evidence-based neonatal medicine in Korea.

No MeSH data available.


Related in: MedlinePlus