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

Autor: Kaplan HC; Perinatal Institute, James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. heather.kaplan@cchmc.org.; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA. heather.kaplan@cchmc.org., Edwards EM; Vermont Oxford Network, Burlington, VT, USA.; Department of Mathematics and Statistics, University of Vermont, Burlington, VT, USA.; Department of Pediatrics, The Robert Larner, M.D. College of Medicine, The University of Vermont, Burlington, VT, USA., Soll RF; Vermont Oxford Network, Burlington, VT, USA.; Department of Pediatrics, The Robert Larner, M.D. College of Medicine, The University of Vermont, Burlington, VT, USA., Morrow KA; Vermont Oxford Network, Burlington, VT, USA., Meyers J; Division of Neonatology, Golisano Children's Hospital, University of Rochester Medical Center, Rochester, NY, USA., Timpson W; Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA, USA.; Department of Pediatrics, Harvard Medical School, Boston, MA, USA., Cohen H; Randall Children's Hospital, Portland, OR, USA., Fry M; Akron Children's Hospital, Akron, OH, USA., Schierholz E; Children's Hospital of Colorado, Aurora, CO, USA.; Data Science to Patient Value, University of Colorado, School of Medicine, Anschutz Medical Campus, Aurora, CO, USA., Buus-Frank ME; Division of Neonatology, The Children's Hospital, Lebanon, NH, USA.; The Dartmouth Institute for Health Policy and Clinical Practice at Geisel School of Medicine, Hanover, NH, USA., Horbar JD; Vermont Oxford Network, Burlington, VT, USA.; Department of Pediatrics, The Robert Larner, M.D. College of Medicine, The University of Vermont, Burlington, VT, USA.
Jazyk: angličtina
Zdroj: Journal of perinatology : official journal of the California Perinatal Association [J Perinatol] 2020 Oct; Vol. 40 (10), pp. 1546-1553. Date of Electronic Publication: 2020 Jul 14.
DOI: 10.1038/s41372-020-0720-3
Abstrakt: 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.
Databáze: MEDLINE
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