National neonatal networks around the world history, organization, function and research※
Evaluation and comparison of outcomes is an effective way of using small area variations to examine how differences in care impact outcomes and provide insights for improving quality of care. This method can also be used to study trends in outcomes over time and their relationship to changes in clinical practices, technology and society. International comparisons offer even greater opportunities for benchmarking, quality improvement and research. In this spirit, the International Network for Comparison of Outcomes (iNEO) was established as a collaboration between 11 countries that have population or regional-based outcomes data from neonatal intensive care units (NICU). The iNEO has been singularly successful and productive, publishing more than 20 manuscripts since its inception in 2014.
The iNEO is a stellar example of what international research collaboration can accomplish and provides a strong foundation for improving quality of care and outcomes on a global scale. It is also unique considering the differences in data collection systems and indicators that were in place and used by different national organizations before the establishment of iNEO. A significant amount of effort was needed to harmonize these datasets in order to make valid comparisons, which speaks to the willingness, cooperativeness and collegiality of the network’s principals and members. Accomplishing this for 11 countries is no small feat, and their successes have attracted interest from other countries that are in the process of joining the iNEO. The iNEO collaboration will expand to research neurodevelopmental outcomes of graduates of NICU in different countries in order to learn how the infants are growing, developing and coping with challenges of daily life.
This series of manuscripts provide detailed description of the individual networks and offer insights into how they were established, how they operate and are managed, how they sustain their operations, and the contributions they make to their patients, society and the world. They make for an eye-opening read and provide a useful guide for others who may be considering establishing networks in their own regions or areas of expertise. Although the networks are mostly from developed Organisation for Economic Co-operation and Development (OECD) countries, we have also included one from China, which is a rapidly developing country whose network will likely become one of the largest in the world.
We also encourage readers to delve beyond this series of manuscripts and explore the many publications from iNEO and the individual networks, as they have contributed greatly to the neonatal literature and our knowledge of how to provide the best care for neonates around the world. In our modern, inter-connected world, collaborations like iNEO provide significant value add to research and efforts to improve care and should be a model for the future.
Acknowledgments
Funding: This study was supported by grant from Canadian Institutes of Health Research.
Footnote
Provenance and Peer Review: This article was commissioned by the editorial office, Pediatric Medicine for the series “Neonatal Networks for Outcomes Improvement: Evolution, Progress and Future”. The article did not undergo external peer review.
Conflicts of Interest: Both authors have completed the ICMJE uniform disclosure form (available at https://pm.amegroups.com/article/view/10.21037/pm-23-4/coif). The series “Neonatal Networks for Outcomes Improvement: Evolution, Progress and Future” was commissioned by the editorial office without any funding or sponsorship. S.K.L. and P.S.S. served as the unpaid Guest Editors of the series. S.K.L. serves as an unpaid editorial board member of Pediatric Medicine from September 2022 to August 2024. S.K.L. reported that Grant funding is received from Canadian Institutes of Health Research. The authors have no other conflicts of interest to declare.
Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.
※Special series on Neonatal Networks for Outcomes Improvements: Evolution, Progress and Future.
