Bridging the Gap: Improving Well-Child Care Engagement Post-discharge in Infants With Neonatal Opioid Withdrawal Syndrome

Abstract

We conducted a quality improvement study to increase well-child visit attendance for infants with neonatal opioid withdrawal syndrome. Our primary outcome was attendance at the postnatal visit. Secondary outcomes included attendance at the 1- and 6-month visits. We used health records data to examine the baseline (2/2022-9/2023) and intervention (1/2024-6/2024) periods. We implemented a series of targeted interventions focused on (1) strengthening community partnerships, (2) increasing support to help families schedule newborn follow-up appointments, and (3) enhancing discharge education. We used Bayesian logistic mixed-effects models to assess follow-up attendance probability. We identified 52 infants in the baseline and 33 infants in the intervention periods. Baseline attendance was 90%, 63%, and 73% at the postnatal, 1-, and 6-month visits, respectively. Following the intervention, attendance was 91% at the postnatal visit, and improved to 82% and 80% for the 1- and 6-month visits. The probability of follow-up increased by 1% (95% confidence interval [CI]: –0.12, 0.12) at the postnatal visit, 18% (95% CI: 0.01, 0.34) at 1 month, and 8% (95% CI: –0.10, 0.24) at 6 months, highlighting the effectiveness of an interdisciplinary approach in improving post-hospitalization follow-up.