Improving Involvement of Families of Small Babies through Family Education, Family Integration, and Multidisciplinary Teamwork: A Quality Improvement Initiative.

Abstract

Introduction: Partnering with and educating families in the neonatal intensive care unit (NICU) is critical for infant neurodevelopment, parent wellness, and family support. Early family integration in care improves both short-term and long-term outcomes. This quality improvement project has 2 specific aims: (1) increase the percentage of small babies (born at <28 wk of gestation or <1000 g) whose families participated in a multidisciplinary family-centered care conference (FCCC) from 0% to 50%, and (2) increase family attendance at the first NICU follow-up clinic from 74% to 90%.

Methods: Using the model for improvement, we conducted plan-do-study-act cycles with iterative interventions to achieve our aims. The FCCCs focused on promoting family involvement at the bedside, infant neurodevelopment, skin-to-skin care, family support, and transitions within the NICU and after discharge. Outcome, process, and balancing measures were tracked and analyzed for special cause variation using statistical process control charts.

Results: Within 18 months, the percentage of infants whose families participated in an FCCC increased from 0% to 39% (48/123). Based on the post-FCCC survey, families found the FCCC helpful in providing information on how they can be involved in their infant's care. They recommended the FCCC to other families, and they expressed interest in a second FCCC focused on preparing for the transition home.

Conclusions: Family participation in a multidisciplinary FCCC increased over time but has not yet achieved the stated goal. We anticipate that further plan-do-study-act cycles will improve adherence to a robust FCCC program by integrating families into their infants' care during critical developmental stages.