RT Journal Article SR Electronic T1 Electronic application to improve management of infections in low-income neonatal units: pilot implementation of the NeoTree beta app in a public sector hospital in Zimbabwe JF BMJ Open Quality JO BMJ Open Qual FD British Medical Journal Publishing Group SP e001043 DO 10.1136/bmjoq-2020-001043 VO 10 IS 1 A1 Hannah Gannon A1 Simbarashe Chimhuya A1 Gwendoline Chimhini A1 Samuel R Neal A1 Liam P Shaw A1 Caroline Crehan A1 Tim Hull-Bailey A1 Rashida A Ferrand A1 Nigel Klein A1 Michael Sharland A1 Mario Cortina Borja A1 Valerie Robertson A1 Michelle Heys A1 Felicity C Fitzgerald YR 2021 UL http://bmjopenquality.bmj.com/content/10/1/e001043.abstract AB There are 2. 4 million annual neonatal deaths worldwide. Simple, evidence-based interventions such as temperature control could prevent approximately two-thirds of these deaths. However, key problems in implementing these interventions are a lack of newborn-trained healthcare workers and a lack of data collection systems. NeoTree is a digital platform aiming to improve newborn care in low-resource settings through real-time data capture and feedback alongside education and data linkage. This project demonstrates proof of concept of the NeoTree as a real-time data capture tool replacing handwritten clinical paper notes over a 9-month period in a tertiary neonatal unit at Harare Central Hospital, Zimbabwe. We aimed to deliver robust data for monthly mortality and morbidity meetings and to improve turnaround time for blood culture results among other quality improvement indicators. There were 3222 admissions and discharges entered using the NeoTree software with 41 junior doctors and 9 laboratory staff trained over the 9-month period. The NeoTree app was fully integrated into the department for all admission and discharge documentation and the monthly presentations became routine, informing local practice. An essential factor for this success was local buy-in and ownership at each stage of the project development, as was monthly data analysis and presentations allowing us to rapidly troubleshoot emerging issues. However, the laboratory arm of the project was negatively affected by nationwide economic upheaval. Our successes and challenges piloting this digital tool have provided key insights for effective future roll-out in Zimbabwe and other low-income healthcare settings.