Colorado Hospitals Substance Exposed Newborns (CHoSEN)

CHoSEN is an initiative to increase consistency in implementation of best practice approaches in the identification of and response to newborns prenatally exposed to substances at the time of birth. Perinatal opioid use and neonatal abstinence syndrome (NAS) is a major public health concern in Colorado.

 In the context of an ongoing opioid epidemic, the incidence of birthing people, infants, and families impacted by opioid use during pregnancy continues to rise. Among hospitals caring for substance-exposed newborns (SENs) and their families in this state, significant variation in clinical and social interventions exists due to lack of robust scientific evidence for practices that optimize maternal and infant outcomes. 

Building upon the work done by states like Massachusetts, Connecticut, and Vermont, the CHoSEN Quality Improvement Collaborative seeks to improve the hospital care of SENs using multi-disciplinary hospital-based improvement teams working collaboratively to achieve measurable improvements. 

Hospital teams use structured quality improvement methods to improve their local practices, including setting specific aims, following appropriate outcome and process measures, and using plan-do-study-act cycles to test and implement changes. Teams collect data on key performance measures to assess progress and drive improvement. Collaboration through open sharing of practices and data is encouraged and supported by regularly publishing toolkits of best practices and resources, community webinars, and twice-yearly statewide forums. 

Learn more about how we’re partnering with the CHoSEN Collaborative to improve care for mothers and newborns impacted by perinatal substance use.

Community Impact

  • CHoSEN is implemented in hospitals accounting for approximately 56% of Colorado births as of March 2023.
  • Since 2017, the average length of stay for substance-exposed newborns has dropped by more than five days.

Program Partners

  • Led in partnership by University of Colorado School of Medicine, Illuminate Colorado, and CPCQC
  • Funded in part by the Colorado Department of Human Services
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Learn More About Participating in CHoSEN

Any hospital with a NICU is eligible to participate. If you are interested in joining the CHoSEN collaborative, please contact us with the individuals at your facility who are interested in joining. From there, we will add you to our email contact list and guide you through the steps to get your team fully onboarded.

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