Colorado Hospitals Substance Exposed Newborns



Colorado Hospitals Substance Exposed Newborns

In this page you will find:

  • Project Overview
  • Project Importance
  • Partners & Participants
  • Approach
  • Resources & Related Content

Project Overview:

The Colorado Hospital Substance Exposed Newborns (CHoSEN) Collaborative in an effort 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 across Colorado. CHoSEN participating hospitals engage in the quality improvement collaborative, but do not actively submit data. CHoSEN QIC are hospitals that engage in the quality improvement collaborative and actively submit data for rapid sequence quality improvement.

Project Importance:

Perinatal opioid use and neonatal abstinence syndrome (NAS) is a major public health concern in Colorado.  In the context of an ongoing epidemic of opioid use and abuse, the incidence of mothers, infants, and families impacted by opioid use during pregnancy continues to rise. Numerous state and community organizations have worked in recent years to improve the care and outcomes for substance exposed newborns (SENs) and their families in Colorado.

Among hospitals caring for 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.  As other U.S. states grapple with this opioid epidemic, perinatal quality collaboratives continue to develop innovative strategies to improve the care of SENs and their families.  Building upon the work done by states like Massachusetts, Connecticut, and Vermont, the CHoSEN Quality Improvement (QI) Collaborative seeks to improve the hospital care of SENs using a quality improvement framework with implementation of a bundle of care practices along with robust data collection and analysis to measure the impact of our work.

Variability across Colorado hospitals exists in maternal and infant drug screening, infant assessment for withdrawal, location of care for opioid exposed newborns, degree of engagement of mothers, pharmacologic treatment modalities, initiation and weaning protocols, criteria for discharge, and many other elements of care.

Partners & Participants:

Since 2015, the CHoSEN collaborative has led the effort to increase consistency in hospital practice at time of birth to identify and respond to prenatal substance exposure with the support of the Colorado SEN Steering Committee, Illuminate Colorado, and the Colorado Department of Human Services.

Current Hospital Members:

  • Banner Health
  • Colorado Children’s Hospital
  • Denver Health
  • Lutheran Medical Center
  • McKee Medical Center
  • Medical Center of the Rockies
  • Memorial Hospital
  • North Colorado Medical Center
  • Parker Adventist Hospital
  • Parkview Medical Center
  • Poudre Valley Hospital
  • Saint Joseph Hospital
  • St. Mary’s Medical Center
  • University of Colorado Hospital


The CHoSEN QI initiative is built around multi-disciplinary hospital-based improvement teams working collaboratively to achieve measurable improvements. Hospital teams will 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 will be asked to collect data on key performance measures, and a shared database with online data entry will be used to assess hospital and statewide progress, and regular progress reports will be returned to hospital teams to drive improvement. Toolkits of best practices and resources for the care of mothers and newborns impacted by perinatal substance use will be made published and updated regularly. Collaboration through open sharing of practices and data will be encouraged, and will be supported by twice-yearly statewide summits and regular webinars.

Helpful Resources & Related Content:

Learn more about the CHoSEN Collaborative at

Ready to Make a Difference?

A steady rise in maternal mortality rates and disparities in infant mortality have increased the spotlight on the quality of care delivered by hospitals and their staff. Together, we can address these issues, improve outcomes and reduce preventable deaths in our state.

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