The Australian and New Zealand Neonatal Network: past achievements and future directions

The care of high-risk newborns in Australia and New Zealand has continued to develop considerably over the last 50 years. The Australian and New Zealand Neonatal Network (ANZNN) was established in 1994. The Network has contributed considerably to the advancement of neonatal care through data collection, collaborative audits, benchmarking, knowledge translation and research. There has been growth from the initial minimum dataset to a sophisticated web-based data capture system facilitating electronic submission, timely data validation and tracking. Collated data are analysed to produce an annual network report covering survival, morbidity and long-term neurodevelopmental outcomes. Automated individual unit feedback is also provided to the centres contributing data. In addition to reporting and benchmarking a range of outcomes, ANZNN strives to improve clinical practice through a range of other shared activities. One important undertaking is through the annual Clinical Practice Improvement (CPI) conference, which includes sessions on improvement methodology, breakout discussion covering key areas of care plus opportunities to share the experience and outcomes from quality improvement projects. The ANZNN CPI committee has organised overseas site visits to learn from other high performing networks; facilitated widespread participation in the Evidence-based Practice for Improving Quality (EPIQ) courses; and partnered with the Royal Australasian College of Physicians (RACP) to participate in the Evolve project to identify a list of the top 5 low-value practices in neonatal care. The CPI functions are further reinforced by ANZNN support for formulating consensus-based Total Parental Nutrition and establishing the Australasian Neonatal Medicine Formulary. Moreover, ANZNN supports the expansion of research capability by providing aggregated outcome data to assist clinical trial design, facilitates surveys including those covering trends and variation in the use of newer technologies, and more recently has undertaken research such as registry-embedded trials. Supporting the data collections of the Australian and New Zealand Neonatal Surgical Network and neonatal retrieval services will add additional dimensions to the ANZNN function. In summary, ANZNN celebrated a 25-year anniversary in 2019 and is still growing and developing geographically and in activities. The strength, longevity and growth of ANZNN are based on active member engagement and sound governance structure.