Evaluation and development of potentially better practices for improving family-centered care in neonatal intensive care units.
OBJECTIVE
Technological and scientific advances have progressively decreased neonatal morbidity and mortality. Less attention has been given to meeting the psychosocial needs of the infant and family than on meeting the infant's physical needs. Parents' participation in making decisions and caring for their child has often been limited. Environments designed for efficient technological care may not be optimal for nurturing the growth and development of sick neonates or their families. Eleven centers collaborating on quality improvement tried to make the care of families better by focusing on understanding and improving family-centered care.


METHODS
Through internal process analysis, review of the evidence, collaborative learning, and benchmarking site visits to centers of excellence in family-centered care, a list of potentially better practices was developed. Choice of which practices to implement and methods of implementation were center specific. Improvement goals were in 3 areas: parent-reported outcomes, staff beliefs and practices, and clinical outcomes in length of stay and feeding practices. Measurement tools for the first 2 areas were developed and pilots were conducted.


RESULTS
Length of stay and feeding outcomes were not different before the collaboration (1998) and at the formal end of the collaboration (2000).


CONCLUSIONS
Prospective parent-reported outcomes are being collected, and the staff beliefs and practices questionnaire will be repeated in all centers to determine the impact of the project in those areas.
Saunders
Roger P
RP
Women's Hospital of Greensboro, Greensboro, North Carolina, USA.
Abraham
Marie R
MR
Crosby
Mary Jo
MJ
Thomas
Karen
K
Edwards
William H
WH
D019985:Benchmarking; D003299:Cooperative Behavior; D003625:Data Collection; D019317:Evidence-Based Medicine; D022143:Family Nursing / Q000592:standards*; D017144:Focus Groups; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000458:organization & administration / Q000592:standards*; D015931:Intensive Care, Neonatal / Q000379:methods* / Q000592:standards; D009936:Organizational Innovation; D009937:Organizational Objectives; D010043:Outcome and Process Assessment, Health Care; D010290:Parents; D011795:Surveys and Questionnaires; D017749:Total Quality Management / Q000379:methods*; D014481:United States