In November 2014, approximately one year after NETS started, a comparison auditing of involved professionals was carried out, to examine NETS Project’s trend. The attending professionals agreed on the effectiveness and the efficacy of Reggio Emilia provincial NETS, in addition to the remarkable result achieved in this experimental step. All provincial birth centres witnessed a step-by-step and smooth organization of neonatal care, in the full acknowledgement of how important neonatal training is: NETS significantly helped creating an effective knowledge of perinatal care. From a healthcare perspecive, NETS turned out effective: no critical events or serious complications were recorded during transport services.
Later, in October 2015 and in October 2016, respectively two and three years after NETS setting up in Reggio Emilia province, auditing of NETS and Assisted transport for pregnant women took place, including all professionals involved.
From September 1st 2013 to October 16th 2016, 164 provincial newborns were admitted to ASMN Neonatology Intensive Care: out of them, 24,4% (n. 40) were NETS services, while 75,6% (n. 124) were recorded as traditional transport services and as such performed by spoke centres.
Most NETS services were classified as appropriate. The main reasons for NETS request were:
suffocation/fetal suffering (15), breathing distress (11), heart condition (2), prematurity (3), sepsis (2), low weight and prematurity (5). Times of assisted transport were analysed and discussed. Starting time (35 minutes), arrival (1 hour), new departure (2 hours) and return (2,56 hours) was a total average 3 hours for each NETS. During the years, a reduced stabilization time turned out, highlighting a better resuscitation effectiveness and better clinical performances of Spoke centers at birth.
Even in the restricted Reggio Emilia experience, NETS turns out as launchpad for a higher centralization of high-risk newborns: during the years, their number shifted from 10 to 45, compared with a steady NETS number. In other words, NETS improves the connection between hub and spoke.
Newborn Transfer Index recorded a slight increase, shifting from 1.1 in 2013 to 2.6 in 2014, and 2.8 in
2015; however, this depends mainly on the specificity of Reggio Emilia perinatal network and is in line with
hospital recommandations to centralize newborns with pathologies, because of special features of provincial
spoke centers and in absence of 24 hours-a-day pediatric doctors on call.
In 3 years, only 11 newborns were premature with GA < 37 ws, while 3 newborns had GA < 32 ws: this value stresses the excellent centralization in Reggio Emilia Province.