A 17.8% drop in newborn vitamin K refusal rates followed Inova Children’s systemwide overhaul from February 2024 to January 2025, after four infants needed PICU care within six months for vitamin K deficiency bleeding.
Refusals had doubled over three years to 10.04 per 1,000 live discharges, prompting Inova to replace uneven site-by-site practices with a standard pathway that flags hesitant families and routes them to bedside talks with hospitalists or neonatologists.
Providers also began using a standardized refusal form signed by both parents and clinicians, while OB-GYNs introduced a 28-week checklist and optional prenatal specialist consults to start discussions earlier.
Community outreach to pediatricians, birthing centers and midwives, plus digital messaging aimed at countering social-media misinformation, broadened the effort as skepticism around newborn care rises nationally.
Inova said refusal rates later edged up from the initial low but remained below starting levels, suggesting the biggest lasting gain was a more consistent, documented process for counseling families.