title: Establishment of a family-centred care programme with follow-up home visits: implications for clinical care and economic characteristics.
abstract: BACKGROUND
  Elternberatung Frühstart is a family-centred care programme for very preterm infants and seriously ill neonates and their parents. The uniqueness of this programme is in its consistency and continuity in parental counselling from pregnancy at risk to follow-up home visits.
  
  
  METHODS
  Family-centred care is provided by specialised nurses, a social education worker, a case manager, a psychologist and neonatologists. They give support and information to parents and facilitate transition to home including co-ordination of health care services and support networks. The programme starts with information for parents at risk of preterm delivery to lessen their anxieties and worries. After birth, parental bonding is encouraged and parents are involved in daily care procedures. The following weeks focus on communication, information and education in order to enhance parental competence. Discharge planning and coordinated follow-up visits involve the family doctor and several members of the welfare and health care system. One of the key objectives is to prevent re-hospitalisation. Over a 4 year period 330 families participated. Funding is provided by: 1) the hospital, from admission to discharge equivalent to one full-time nursing staff, 2) charity donations for follow-up visits and 3) health care insurance for social medical aftercare (Bunter Kreis) following §43, 2 SGB V in severe cases.
  
  
  RESULTS
  As a result of this programme, the median length of stay was reduced by 24 days; the number of patients that stayed longer than average were reduced by 64% in the group of patients born < 1 500 g. At the same time the patient throughput increased from 243 to 413.
  
  
  CONCLUSIONS
  To conclude, a family-centred care programme with coordinated follow-up increases parental satisfaction, reduces the length of the hospital stay and is therefore profitable.
authors.affiliation: Department of Neonatology, University Children's Hospital Essen, Essen, Germany. Britta.Huening@uk-essen.de
authors.forename: B M
authors.initials: BM
authors.lastname: Hüning
authors.forename: M
authors.initials: M
authors.lastname: Reimann
authors.forename: U
authors.initials: U
authors.lastname: Beerenberg
authors.forename: A
authors.initials: A
authors.lastname: Stein
authors.forename: A
authors.initials: A
authors.lastname: Schmidt
authors.forename: U
authors.initials: U
authors.lastname: Felderhoff-Müser
mesh_terms: D003299:Cooperative Behavior; D017046:Cost Savings; D022143:Family Nursing / Q000191:economics; D005260:Female; D005858:Germany; D006701:Home Nursing / Q000193:education; D006792:House Calls / Q000191:economics; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000191:economics / Q000451:nursing*; D007363:Intensive Care Units, Neonatal / Q000191:economics; D033183:Interdisciplinary Communication; D007902:Length of Stay / Q000191:economics; D008297:Male; D009313:National Health Programs / Q000191:economics; D010290:Parents / Q000193:education; D010348:Patient Care Team / Q000191:economics; D010351:Patient Discharge / Q000191:economics; D010359:Patient Readmission / Q000191:economics; D011247:Pregnancy