A Comprehensive and Collaborative Approach to Improving Small Baby Care and Outcomes.

Extremely preterm infants (EPIs) require complex management because of structural and functional organ immaturity leading to unique medical needs and evolving approaches throughout their NICU course because of changes in physiology. A comprehensive approach to care for these small babies is essential, as changes in management of one organ system can have downstream effects on others. This care plan ideally begins before delivery and involves a multidisciplinary team developing the initial plan of care based on individual patient factors and continues to evolve. Because of the complexity of these fragile patients, multidisciplinary guidelines developed by a team with expertise in caring for EPIs can lead to improved care and outcomes. Additionally, multicenter collaboration to share knowledge and experience, work together on research and quality improvement initiatives, and discuss complicated cases is essential because of the relatively small numbers of these tiniest patients at each individual site.