title: Introduction of microsystems in a level 3 neonatal intensive care unit-an interprofessional approach.
abstract: Growth of neonatal intensive care units in number and size has raised questions towards ability to maintain continuity and quality of care. Structural organization of intensive care units is known as a key element for maintaining the quality of care of these fragile patients. The reconstruction of megaunits of intensive care to smaller care units within a single operational service might help with provision of safe and effective care.
  
  
  
  The clinical team and patient distribution lay out, admission and discharge criteria and interdisciplinary round model was reorganized to follow the microstructure philosophy. A working group met weekly to formulate the implementation planning, to review the adaptation and adjustment process and to ascertain the quality of implementation following the initiation of the microsystem model.
  
  
  
  In depth examination of microsystem model of care in this study, provides systematic evaluation of this model on variable aspects of health care. The individual projects of this trial can be source of solid evidence for guidance of future decisions on optimized model of care for the critically ill newborns.
  
  
  
  ClinicalTrial.gov, NCT02912780 . Retrospectively registered on 22 September 2016.
authors.affiliation: Division of Neonatology, Department of Pediatrics, McMaster University, Hamilton, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
authors.forename: Salhab
authors.initials: S
authors.lastname: El Helou
authors.affiliation: Division of Neonatology, Department of Pediatrics, McMaster University, Hamilton, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
authors.forename: Samira
authors.identifier: 0000-0002-8137-4383
authors.initials: S
authors.lastname: Samiee-Zafarghandy
authors.affiliation: Division of Neonatology, Department of Pediatrics, McMaster University, Hamilton, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Fusch
authors.affiliation: Division of Neonatology, Department of Pediatrics, McMaster University, Hamilton, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
authors.forename: Muzafar Gani Abdul
authors.initials: MG
authors.lastname: Wahab
authors.affiliation: Division of Neonatology, Department of Pediatrics, McMaster University, Hamilton, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
authors.forename: Lynda
authors.initials: L
authors.lastname: Aliberti
authors.affiliation: Division of Neonatology, Department of Pediatrics, McMaster University, Hamilton, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Bakry
authors.affiliation: Division of Neonatology, Department of Pediatrics, McMaster University, Hamilton, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
authors.forename: Deborah
authors.initials: D
authors.lastname: Barnard
authors.affiliation: Division of Neonatology, Department of Pediatrics, McMaster University, Hamilton, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
authors.forename: Joanne
authors.initials: J
authors.lastname: Doucette
authors.affiliation: Division of Neonatology, Department of Pediatrics, McMaster University, Hamilton, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
authors.forename: Enas
authors.initials: E
authors.lastname: El Gouhary
authors.affiliation: Division of Neonatology, Department of Pediatrics, McMaster University, Hamilton, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Marrin
authors.affiliation: Division of Neonatology, Department of Pediatrics, McMaster University, Hamilton, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
authors.forename: Carrie-Lynn
authors.initials: CL
authors.lastname: Meyer
authors.affiliation: Division of Neonatology, Department of Pediatrics, McMaster University, Hamilton, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
authors.forename: Amit
authors.initials: A
authors.lastname: Mukerji
authors.affiliation: Division of Neonatology, Department of Pediatrics, McMaster University, Hamilton, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
authors.forename: Anne
authors.initials: A
authors.lastname: Nwebube
authors.affiliation: Division of Neonatology, Department of Pediatrics, McMaster University, Hamilton, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Pogorzelski
authors.affiliation: Division of Neonatology, Department of Pediatrics, McMaster University, Hamilton, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
authors.forename: Edward
authors.initials: E
authors.lastname: Pugh
authors.affiliation: Division of Neonatology, Department of Pediatrics, McMaster University, Hamilton, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
authors.forename: Karen
authors.initials: K
authors.lastname: Schattauer
authors.affiliation: Division of Neonatology, Department of Pediatrics, McMaster University, Hamilton, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
authors.forename: Jay
authors.initials: J
authors.lastname: Shah
authors.affiliation: Division of Neonatology, Department of Pediatrics, McMaster University, Hamilton, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
authors.forename: Sandesh
authors.initials: S
authors.lastname: Shivananda
authors.affiliation: Division of Neonatology, Department of Pediatrics, McMaster University, Hamilton, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
authors.forename: Sumesh
authors.initials: S
authors.lastname: Thomas
authors.affiliation: Division of Neonatology, Department of Pediatrics, McMaster University, Hamilton, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Twiss
authors.affiliation: Division of Neonatology, Department of Pediatrics, McMaster University, Hamilton, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
authors.forename: Connie
authors.initials: C
authors.lastname: Williams
authors.affiliation: Division of Neonatology, Department of Pediatrics, McMaster University, Hamilton, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
authors.forename: Sourabh
authors.initials: S
authors.lastname: Dutta
authors.affiliation: Division of Neonatology, Department of Pediatrics, McMaster University, Hamilton, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada. fusch@mcmaster.ca.|Department of Pediatrics, General Hospital, Paracelsus Medical School, Nuremberg, Germany. fusch@mcmaster.ca.
authors.forename: Christoph
authors.initials: C
authors.lastname: Fusch
mesh_terms: D002170:Canada / Q000453:epidemiology; D003266:Continuity of Patient Care / Q000458:organization & administration* / Q000592:standards; D016638:Critical Illness / Q000628:therapy*; D020000:Decision Support Systems, Clinical / Q000458:organization & administration*; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000458:organization & administration / Q000592:standards; D033183:Interdisciplinary Communication; D010351:Patient Discharge; D015397:Program Evaluation; D011787:Quality of Health Care / Q000592:standards*
keywords: Microsystem; Neonatal intensive care unit; Organizational structure; Quality care