RESEARCH ARTICLE 195 | AUTHORS Elizabeth Simpson, MD, 1 Neera K. Goyal, MD, MSHP, 2 Niramol Dhepyasuwan, MEd, 3 Valerie J. Flaherman, MD, MPH, 4 Esther K. Chung, MD, MPH, 5 Isabelle Von Kohorn, MD, PhD, 6 Anthony Burgos, MD, 7 James Taylor, MD 8 1 University of Missouri–Kansas City School of Medicine, Children’s Mercy Hospital Kansas City, Missouri; 2 Division of Neonatology and Division of Hospital Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio; 3 Academic Pediatric Association, McLean, Virginia; 4 University of California at San Francisco, San Francisco, California; 5 Nemours and Jefferson Medical College, Philadelphia, Pennsylvania; 6 Holy Cross Health, Silver Spring, Maryland; 7 Well Newborn Care, Kaiser Permanente, Downey, California; and 8 Department of Pediatrics, University of Washington, Seattle, and Newborn Nursery, University of Washington Medical Center, Seattle, Washington KEY WORDS academic medical centers, Delphi technique, infant, newborn, nursery ABBREVIATIONS AAP: American Academy of Pediatrics BORN: Better Outcomes through Research for Newborns GBS: group B streptococcus PROS: Pediatric Research in Office Settings www.hospitalpediatrics.org doi:10.1542/hpeds.2014-0003 Address correspondence to Elizabeth Simpson, MD, General Pediatrics/Broadway Clinics, 2401 Gillham Rd, Kansas City, MO 64108. E-mail: easimpson@cmh.edu HOSPITAL PEDIATRICS (ISSN Numbers: Print, 2154 - 1663; Online, 2154 - 1671). Copyright © 2014 by the American Academy of Pediatrics In the United States, birth newborn hospitalizations outnumber those for all other pediatric age groups combined at a ratio of ∼3 to 1. 1 More than 90% of all new- borns are cared for in routine birth hospital settings outside of NICUs. 2,3 In a 2004 policy statement, the American Academy of Pediatrics (AAP) stated that routine newborn hospital care is essential for a safe, healthy transition home. 4 Outcomes related to the newborn hospitalization such as breastfeeding rates and readmission increasingly represent areas for quality measurement in pediat- ric hospital care. Moreover, national trends, such as the rise in the late preterm birth rate and the more recent increase in the incidence of neonatal abstinence syndrome, underscore the importance of effective approaches to routine new- born hospital care to prevent adverse outcomes. Although routine newborn care represents such a large proportion of all pediatric hospital care, few specific rou- tine newborn interventions have been rigorously evaluated. In the absence of a good evidence base, clinicians caring for newborns may rely on varying historical practices and individual clinical judgment. To develop a more robust and useful Prioritizing a Research Agenda: A Delphi Study of the Better Outcomes Through Research for Newborns (BORN) Network (Continued on last page) abstract BACKGROUND: There is a paucity of evidence to guide clinical management for term and late preterm newborns. The Better Outcomes through Research for Newborns (BORN) network is a national collaborative of clinicians formed to increase the evidence-base for well newborn care. OBJECTIVE: To develop a consensus-based, prioritized research agenda for well newborn care. DESIGN: A two-round modified Delphi survey of BORN members was conducted. Round 1 was an open-ended survey soliciting 5 clinical questions identified as important and under-researched. Using qualitative methods, 20 most common themes were extracted and transformed into research questions. Round 2 survey respondents ranked the top 20 questions using a 5- point Likert scale and a quantitative analysis was conducted. RESULTS: Round 1 survey generated 439 unique research questions that fell into 57 themes. In the Round 2 survey, the highest rated questions were: 1) At what weight-loss percentage is it medically necessary to formula supplement a breastfeeding infant? 2) What is the optimal management of infants with neonatal abstinence syndrome? 3) How and when should we initiate a workup for sepsis, and how should these newborns be managed? CONCLUSIONS: Research priorities of clinicians include criteria for medically indicated formula supplementation of the breastfed newborn, management of neonatal abstinence syndrome and management of newborns at-risk for sepsis.