Story of Merge: Episode 4

Does Merge^TM work in the ‘real world’ for all preterm babies and their parents?

Our team wanted to know if the positive results from a clinical trial could be replicated in the real world with every preterm baby admitted to any type of neonatal intensive care unit (NICU)? The short answer is, “yes”. With only 10/14 sites fully implementing Merge^TM due to pauses related to the COVID-19 pandemic and the roll out of a new provincial electronic medical record, we continued to see an average reduction in length of stay of 0.41 days with a cumulative value created for the health system of $1.96 million dollars. In addition, there were no statistically significant differences in post-discharge emergency department visits or hospital readmissions, which means that implementing Merge^TM did not download earlier NICU discharge to other parts of the health system.

The next logical question was, “Can these positive results in the be sustained over time?” Again, the short answer is, “yes.” Eighteen months after all 14 sites implemented Merge^TM, we continued to see an average reduction in length of stay of half a day with a cumulative value created of $5.3 million dollars. Again, there were no statistically significant differences in post-discharge emergency department visits and hospital readmissions, which means that implementing Merge^TM did not download earlier NICUs discharge to other parts of the health system and this effect was sustained over time. With these results, we demonstrated effectiveness of Merge^TM in the ‘real world’. That is, with Merge^TM the health system delivered better quality care anMerge and achieved better outcomes at a lower cost. Essentially, we achieved at least three of the four criteria of the Quadruple Aim, often thought of as the holy grail’ of health services.