Transform Your NICU (Quality Improvement)

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What are four ways your NICU can work to improve the ways you provide psychosocial support to NICU parents?

  1. Start by convening an interdisciplinary task force or committee to review the Interdisciplinary Recommendations for Psychosocial Support of NICU Parents, and then perform a Self-Assessment using the tool we have developed for this.
  2. Be sure to involve both hospital and NICU leadership for both the nursing and medical teams, to ensure their buy-in and support.
  3. Work collaboratively with an interdisciplinary team to develop a comprehensive family support policy, including mission and vision statements, which could set the tone and establish the unit’s culture and commitment to supporting families in as many ways as possible.
  4. Identify and begin to work on specific quality improvement projects, derived from the Recommendations or from other opportunities that are specific to your NICU’s environment.

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Bibliography on NICU Quality Improvement:  Includes references on general topics in quality improvement in neonatology, QI projects related to psychosocial support of NICU parents, and QI projects in clinical neonatology.  Prepared by the Workgroup for Psychosocial Support of NICU Parents.

NPA NICU Self-Assessment (Oct. 2016):  Begin your NICU’s Quality Improvement process by performing a self-assessment to determine how comprehensive your provision of family support is currently.  What are you doing well?  What are you not doing, that you could or should be doing?  And what are you working on that has not yet been realized?  Engage your team in this worthwhile exercise and watch your score increase on successive measurements as you move towards comprehensive family support.  (Note: This form is updated/improved periodically.)

Quality Improvement Worksheet:  Use this tool to help outline your strategy:  What do you propose to change and how will you measure it?  What are opportunities for improvement and barriers you might encounter?  What resources are needed?  And what might be first steps?

Top Ten Recommendations:  These are what we consider to be the “top ten” recommendations; one of these might be a starting point for change in your NICU.

Talking Points about Hiring a NICU Psychologist and Talking Points About Starting a Peer Support Program:  These documents outline rationale for two key elements of comprehensive family support that require “buy-in” from both NICU and hospital administration:  hiring a NICU psychologist and starting or partnering with a peer support organization.  The “value added” propositions are outlined, as well as programmatic issues to consider and potential roadblocks.  These are the “talking points” you need to take to your meeting with hospital administrators to pitch your case!

Job Description for NICU Psychologist:  This job description, written from a compilation of descriptions from several different NICUs, is provided as a resource for hospitals/NICUs wanting to hire a psychologist but needing some direction in developing a job description.

Transforming NICU Care to Provide Comprehensive Family SupportAn article published by members of the NPA workgroup  in the journal Newborn and Infant Nursing Reviews in 2016 describing a quality improvement approach to implementation of the Recommendations for Psychosocial Support in your NICU.

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IHI Improvement Project Roadmap:  This will help guide you to getting where you want to go with your QI project.  You have to register to download the form.

IHI’s Collaborative Model for Achieving Breakthrough Improvement:  A White Paper explaining IHI’s model.

IHI’s Project Planning form:  This is a useful tool for planning an entire improvement project, including a listing of all of the changes that the team is testing, all of the Plan-Do-Study-Act (PDSA) cycles for each change, the person responsible for each test of change, and the timeframe for each test.

A Primer on Quality Improvement Methodology In Neonatology, an article by Dan Ellsbury and Robert Ursprung which appeared in Clinics in Perinatology, 2010.

Here is a Roadmap for a QI project to improve rates of Kangaroo Care in your NICU, as described by the team at U Mass Memorial Hospital.

CDC’s new Guidelines for Developing and Sustaining Perinatal Quality Collaboratives are available for download.

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Institute for Healthcare Improvement (IHI):  This is a major improvement driving quality improvement throughout all of healthcare.  It has a variety of resources, tools, case studies, and white papers on the topic of systems change in healthcare.

Vermont Oxford Network:  This is one of the most established and primary Quality Improvement Collaboratives active in neonatology in the U.S.  Hospitals have to become members to access all the services and benefits, and to participate in building the database and in the QI projects.

National Quality Forum:  This is another national organization leading the way in quality improvement science in medicine.

Agency for Healthcare Research and Quality:  Sponsored by the U.S. Department of Health and Human Services, this organization’s mission is to produce evidence to make health care safer, higher quality, more accessible, equitable, and affordable.

100px speakersSpeakers Bureau

Are you interested in having someone speak to your staff, organization, or network about best practices in peer-to-peer support?  Click on the icon to go to our Speaker’s Bureau page to learn more about these speakers.

Sue Hall, MD, Neonatologist