Variability in the systems of care supporting critical neonatal intensive care unit transitions

J Perinatol. 2020 Oct;40(10):1546-1553. doi: 10.1038/s41372-020-0720-3. Epub 2020 Jul 14.

Abstract

Objective: Assess practices supporting care transitions for infants and families in the neonatal intensive care unit (NICU) using a model of four key drivers: communication, teamwork, family integration, and standardization.

Study design: Single-day audit among NICUs in the Vermont Oxford Network Critical Transitions collaborative addressing policies and practices supporting the four key drivers during admission, discharge, shift-to-shift handoffs, within hospital transfers, and select changes in clinical status.

Results: Among 95 NICUs, the median hospital rate of audited policies in place addressing the four key drivers were 47% (inter-quartile range (IQR) 35-65%) for communication, 67% (IQR 33-83%) for teamwork, 50% (IQR 33-61%) for family integration, and 70% (IQR 56-85%) for standardization. Of the 2462 infants included, 1066 (43%) experienced ≥1 specified transition during the week prior to the audit.

Conclusions: We identified opportunities for improving NICU transitions in areas of communication, teamwork, family integration, and standardization.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Hospitals
  • Humans
  • Infant
  • Infant, Newborn
  • Intensive Care Units, Neonatal*
  • Patient Discharge*
  • Vermont