ArticleBMJ open quality2026
Timely care for tiny lives: quality improvement for golden hour management bundle.
Article in BMJ open quality, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPreterm babies face a high risk of hypothermia, respiratory distress and hypoglycaemia soon after birth. The golden hour-the first 60 min of life-has been shown to improve outcomes with evidence-based, timely interventions. An audit in our neonatal intensive care unit (NICU) in central India showed that only 7.7% of preterms received the golden hour management bundle (GHMB).
methodsThis quasi-experimental study was conducted between May 2023 and May 2025 in inborn preterms <34 weeks. A multidisciplinary team used process mining and root cause analysis to identify delays in GHMB. Multiple plan-do-study-act (PDSA) cycles were conducted, including revised delivery room transfer policies, dedicated resident role allocation, thermal care practices, ventilator and consumables buffer stock and preprepared intravenous cannula trays. Data were collected prospectively and analysed using time-motion analysis and statistical process control charts.
resultsA total of 294 preterms were studied. The median time to complete GHMB decreased from 107 min at baseline to 55 min in the sustainability phase (p<0.001). The percentage of preterms receiving GHMB rose from 7.7% to 71.7%. The rate of moderate hypothermia at admission decreased from 100% to 12.1%. Timely intravenous fluid administration improved from 12.5% to 80.4%, and medications within the first hour increased from 4.1% to 71%.
conclusionProcess mining helped identify and reduce rate-limiting steps as well as reorganise and reassign tasks, thereby improving the proportion of preterms receiving GHMB.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.