A. Eligibility. Population Criteria
- Any (Small Baby) infant who is born at your hospital and whose birth weight is between 401 and 1,500 grams OR whose gestational age is between 22 weeks 0 days and 29 weeks 6 days (inclusive) is eligible, regardless of where in your hospital the infant receives care.
- Any outborn (Small Baby) infant who is admitted to any location in your hospital within 28 days of birth and whose birth weight is between 401 and 1,500 grams OR whose gestational age is between 22 weeks 0 days and 29 weeks 6 days (inclusive) is eligible, regardless of where in your hospital the infant receives care.
In summary, any Small Baby infant is automatically eligible into the CPQCC database. However, any Small Baby infant who was previously discharged home from a hospital will not be forwarded to VON.
- Any (Big Baby) infant who is born at or admitted to your hospital within 28 days of birth, with a birth weight that is greater than 1,500 grams MUST also meet one of the following 8 criteria:
- Acute Transfer-In
- Nasal IMV/SIMV (or any other form of non-intubated assisted ventilation) for greater than four continuous hours (for 2009 and later)
- Intubated Assisted Ventilation for greater than four continuous hours
- Early Bacterial Sepsis
- Major surgery requiring Anesthsia
- Previously discharged Home and Readmitted to your hospital for Total Serum Bilirubin => 25mg/dL (427 micromols/Liter) and/or exchange transfusion
- Acute Transfer-Out of your NICU
Q: If a Big Baby is transferred-in to my hospital, but is admitted to a different unit and is not cared for by a Neonatologist there, is this baby eligible?
A: No. A Big Baby "NICU infant" must either be admitted to the NICU regardless of physician OR cared for by a Neonatologist, or the NICU staff if admitted to any other unit of your hospital.
Q: If a Big Baby is transferred to my hospital from another hospital, then admitted to another unit (and not to the NICU) but is still under the care of a Neonatologist, is this infant eligible?
A: Yes, if the infant was admitted by Day 28 and was cared for by a neonatologist in any other unit in your center EXCEPT for the delivery room.
Day 28 Cut-off
Q: We have an infant that was transferred-in at 35 days of life. Does the 28-Day rule apply to transfers?
A: Yes, the 28-Day rule does apply for transfers. However, only fill out the form if the infant was first admitted to your NICU on or before Day 28 of life. This particular infant would NOT qualify.
Q: Should an infant be counted who qualifies after Day 28?
A: A Big Baby who is admitted into the NICU on or before Day 28 is still eligible into the database even if the following selection criteria occur AFTER Day 28:
- NASAL IMV/SIMV (or any other form of non-intubated assisted ventilation) for greater than four continuous hours
- Intubated assisted Ventilation for greater than four continuous hours, or
- Major surgery requiring anesthesia
- Previously Discharged Home and Readmitted to your hospital for Total Serum Bilirubin => 25mg/dL
Q: A qualified two-month old infant is transferred to the third hospital. Does this infant count after Day 28?
A: To be eligible into the database, Small Baby infants must be born or admitted to any location in your hospital within 28 days of birth without first having been discharged home to be eligible. Any Big Baby infant who is admitted on or before Day 28 of life to the NICU or cared for by Neonatologist to be eligible, and then must fulfill one of the eight selection criteria listed above for Big Babies.
Here are a few examples to clarify the situation above:
- If the two-month old infant was eligible into the database on or before Day 28 at Hospital A, then was transferred to Hospital B for acute reasons on or before Day 28, and then transferred to Hospital C on or before Day 28, then that infant would be eligible and assigned an ID by all three hospitals.
- If the two-month old infant was transferred to Hospital B AFTER Day 28, then that infant wouldn't be eligible for Hospital B or Hospital C.
- If this same infant that was transferred to Hospital B on or before Day 28 is transferred back to Hospital A (even if it's after Day 28), then this infant's record in Hospital A would be updated based on the interventions that was performed at Hospital B using the Readmission Instructions in the current CPQCC Manual.
Q: Does an infant who is admitted from home and never admitted to the NICU (for example, a cardiac kid who didn't declare himself until 3-5 days of life, and has already been discharged from the hospital) qualify for the database?
A: If the infant was never admitted to the NICU, and is being readmitted from home, the only way it would qualify is for the hyperbilirubinemia. You will need to record this infant in the database if the following has also occured:
- The infant was a Small Baby that was admitted to your hospital on or before Day 28 of life.
- The infant was a Big Baby that was admitted to your hospital on or before Day 28 of life and meets one of the 8 Big Baby Criteria.
B. Eligibility. Very Low Birth Weight Infants
Q: An infant, who is less than 401g and less than 22 weeks gestational age at birth is transferred to my hospital at 6 weeks. Is this infant eligible? Is this an acute or non-acute transfer?
A: An infant that is less than 401g in weight and less than 22 weeks at birth is NOT eligible for the CPQCC selection criteria and should not be recorded in the CPQCC Network Database. Very Low Birth Weight infants (Small Babies) which are automatically eligble into the CPQCC Network Database are defined by the following two conditions:
- Birth weight between 401-1,500 grams
- Gestational Age is between 22 weeks 0 days and 29 weeks 6 days. any out-born infant, who meets one of the above criteria AND who is admitted to any location in your hospital within 28 days of birth without first having gone home, is eligible. These infants are eligible regardless if the transfer was acute or non-acute.
C. Eligibility. Selection Criteria for Infants with birth weight > 1,500 grams
1. Acute Transfers
Note: An infant that is considered an Acute Transfer-In requires submission of the TRS form for the purpose of the Transfer Data System.
Q: Please clarify the difference between an "Acute Transfer" and a "Non-Acute Transfer".
A: Acute Transfer is defined as: "An Acute transfer is an infant with medical problems that require acute resolution for survival who is transferred in order to obtain medical, diagnostic, or surgical therapy that is not provided, or that cannot be provided due to temporary staffing/census issues. or that cannot be provided due to insurance restrictions at the referring hospital is considered acute." Technically a transfer is from one acute-care facility to another, therefore, clinics and ambulance transfers from home do not qualify.
A non-acute transfer is an infant whose initial medical/surgical needs have been met, whose condition has been stabilized and who is transferred to a facility in order to obtain growth care, discharge planning care, chronic care, and/or hospice care. The medical needs of non-acute transfers may range from extensive and extremely complex care (e.g., an infant with lethal anomalies) to minimal care for feeding and growth (e.g., "maintenance").
Note: Infants transferred from one unit to another within your hospital are not considered to have been transferred or discharged.
Q. Does an infant transferred from a clinic using Children's Transport Services eligible?
A: No, the infant is only an acute transfer if he/she is transferred from one acute-care facility to another.
Q: Is an out-born infant that is transferred by ambulance to the NICU with no other qualifying criteria an acute transfer-in?
A: Only if it is a Small Baby that was transferred to your hospital on or before 28 days of life.
Q: A grower/feeder with an IV is transferred to our hospital in order to make space for an infant that we need to transfer them. They won't take our infant unless we take theirs because they don't have enough bed space. Is this an acute transfer in?
A: If the infant is a Small Baby and was transferred by Day 28 of life then yes, because it falls under the CPeTS criteria of "bed availability". Therefore, a TRS form is required for this infant.
Q: An infant that was not eligible before is now transferred for census. Is this infant eligible as an acute transfer out? Or is the baby still not eligible?
A: Yes, if the infant was a Small Baby. If the infant was a Big Baby, then it MUST be admitted to the NICU on or before Day 28 of life prior to transferring out of your hospital census issues.
Q: An infant that did not qualify previously gets transferred out/in for feeding and growing (i.e antibiotics), census or insurance issues. Does this baby now qualify as an Acute Transfer out/in?
A: If a Big Baby is transferred from another hospital to your hospital for feeding and growing (non-Acute Transfer) only then the baby is NOT eligible. If the same baby is transferred for census/insurance (Acute Transfer) reasons, then the baby is eligible and qualifies as an Acute Transfer. You would then need to fill out a TRS (Transport) form and mark census or insurance as the transferring reason.
Q: Would the following be accepted as Acute Transfer-in, infants born at home, ER or Birthing Center?
A: An Acute Transfer only qualifies if the baby is coming from one "in-patient" facility to another. Therefore, infants coming from home, the ER or a Birthing Center does not qualify as an Acute Transfer to your hospital and you should not fill out the TRS (Transport) form. However, if this baby meets the Small Baby or Big Baby CPQCC criteria then it would be recorded as an out-born admission into your NICU if admitted on or before Day 28 of life.
Q: I had a Big Baby transfer out for services to another hospital after 28 days of life, would this still qualify as an acute transfer?
A: Yes, you would still record this information provided the infant was admitted to your NICU prior to or by 28 days of life. The baby would be recorded as an acute transfer out of your hospital for Medical/Diagnostic services on the CPQCC Admission/Discharge form only.
Q: Are infants considered transferred-in when they are technically moved from one hospital to another, even though it's the same building? For example, LPCH at Washington admitted from the co-located Washing Hospital OR LPCH Sequoia admitted from the co-located Sequoia Hospital...same physical site, but technically different hospitals.
A: No, starting with infants born in 2008, CPeTS has clarified that an infant born in the co-located hospital and then admitted to the Satellite NICU (e.g. a NICU owned and managed by the organization located within a delivery facility owned and managed by another hospital) is not considered a CPeTS Acute Inter-facility Transport for the purpose of the Transport Data System. No on-line CPeTS form (TRS form) is required.
However, an infant that is moved from one NICU to another NICU that is separated by a bridge would require a CPeTS form and considered a Special Situation - Self-Transport if the NICUs do not have a Satellite NICU - co-located Hospital relationship
Q: We administratively discharge an infant from the NICU who goes for post-op surgical services and then is readmitted to the NICU. Is this one admission or two separate admissions for CPQCC purposes?
A: For CPQCC this situation is considered as one admission until the baby is discharged from the hospital.
Q: If an infant is born at home, then admitted to our ER, and then transferred to the NICU. Is this baby eligible into the database?
A: If this is a Small Baby that was admitted to the NICU on or before Day 28 of life, then it would be recorded as an out-born admission. If this is a Big Baby that was admitted on or before Day 28 AND met one of the other Big Baby criteria then she/he would be recorded as an out-born admission.