PMID- 32665688
OWN - NLM
STAT- MEDLINE
DCOM- 20210831
LR  - 20220218
IS  - 1476-5543 (Electronic)
IS  - 0743-8346 (Print)
IS  - 0743-8346 (Linking)
VI  - 40
IP  - 10
DP  - 2020 Oct
TI  - Variability in the systems of care supporting critical neonatal intensive care 
      unit transitions.
PG  - 1546-1553
LID - 10.1038/s41372-020-0720-3 [doi]
AB  - 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.
FAU - Kaplan, Heather C
AU  - Kaplan HC
AD  - Perinatal Institute, James M. Anderson Center for Health Systems Excellence, 
      Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. 
      heather.kaplan@cchmc.org.
AD  - Department of Pediatrics, University of Cincinnati College of Medicine, 
      Cincinnati, OH, USA. heather.kaplan@cchmc.org.
FAU - Edwards, Erika M
AU  - Edwards EM
AD  - Vermont Oxford Network, Burlington, VT, USA.
AD  - Department of Mathematics and Statistics, University of Vermont, Burlington, VT, 
      USA.
AD  - Department of Pediatrics, The Robert Larner, M.D. College of Medicine, The 
      University of Vermont, Burlington, VT, USA.
FAU - Soll, Roger F
AU  - Soll RF
AD  - Vermont Oxford Network, Burlington, VT, USA.
AD  - Department of Pediatrics, The Robert Larner, M.D. College of Medicine, The 
      University of Vermont, Burlington, VT, USA.
FAU - Morrow, Kate A
AU  - Morrow KA
AD  - Vermont Oxford Network, Burlington, VT, USA.
FAU - Meyers, Jeffrey
AU  - Meyers J
AD  - Division of Neonatology, Golisano Children's Hospital, University of Rochester 
      Medical Center, Rochester, NY, USA.
FAU - Timpson, Wendy
AU  - Timpson W
AD  - Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
AD  - Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
FAU - Cohen, Howard
AU  - Cohen H
AD  - Randall Children's Hospital, Portland, OR, USA.
FAU - Fry, Marybeth
AU  - Fry M
AD  - Akron Children's Hospital, Akron, OH, USA.
FAU - Schierholz, Elizabeth
AU  - Schierholz E
AD  - Children's Hospital of Colorado, Aurora, CO, USA.
AD  - Data Science to Patient Value, University of Colorado, School of Medicine, 
      Anschutz Medical Campus, Aurora, CO, USA.
FAU - Buus-Frank, Madge E
AU  - Buus-Frank ME
AD  - Division of Neonatology, The Children's Hospital, Lebanon, NH, USA.
AD  - The Dartmouth Institute for Health Policy and Clinical Practice at Geisel School 
      of Medicine, Hanover, NH, USA.
FAU - Horbar, Jeffrey D
AU  - Horbar JD
AD  - Vermont Oxford Network, Burlington, VT, USA.
AD  - Department of Pediatrics, The Robert Larner, M.D. College of Medicine, The 
      University of Vermont, Burlington, VT, USA.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20200714
PL  - United States
TA  - J Perinatol
JT  - Journal of perinatology : official journal of the California Perinatal 
      Association
JID - 8501884
SB  - IM
MH  - Hospitals
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - *Intensive Care Units, Neonatal
MH  - *Patient Discharge
MH  - Vermont
PMC - PMC7359434
COIS- The authors declare that they have no conflict of interest.
EDAT- 2020/07/16 06:00
MHDA- 2021/09/01 06:00
PMCR- 2020/07/14
CRDT- 2020/07/16 06:00
PHST- 2019/12/13 00:00 [received]
PHST- 2020/07/07 00:00 [accepted]
PHST- 2020/06/02 00:00 [revised]
PHST- 2020/07/16 06:00 [pubmed]
PHST- 2021/09/01 06:00 [medline]
PHST- 2020/07/16 06:00 [entrez]
PHST- 2020/07/14 00:00 [pmc-release]
AID - 10.1038/s41372-020-0720-3 [pii]
AID - 720 [pii]
AID - 10.1038/s41372-020-0720-3 [doi]
PST - ppublish
SO  - J Perinatol. 2020 Oct;40(10):1546-1553. doi: 10.1038/s41372-020-0720-3. Epub 2020 
      Jul 14.