| Sumario: | The achievement of optimal brain health in very preterm babies is a challenge for modern neonatology. There has been limited success in this area of concern despite improvements in other neonatal outcomes. The barriers to progress are (a) the language and definitions that clinicians and scientists use to describe outcomes, (b) our representation of causation, and (c) the rigour with which we apply quality improvement science. Quality improvement science requires clear, relevant, and discriminating language to explain aims, drivers, processes, outcomes, interventions, and definitions. To date, clinical guidelines and research publications have not addressed prevailing flaws in language, causation, and definition. The persisting flaws have restricted identification of quality improvement opportunities and limited the impact of quality improvement efforts. Our community of neonatal caregivers and researchers needs a new and comprehensive approach to language, causation, and implementation science in order to address brain health in very preterm babies.
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