Redesigning care to support earlier discharge from a neonatal intensive care unit: a design thinking informed pilot

BMJ Open Quality

article

Shoshana H Bardach¹  Amanda N Perry¹  Nirav S Kapadia¹  Kathryn E Richards²  Laura K Cogswell²  Tyler K Hartman² 

[1] The Dartmouth Institute for Health Policy and Clinical Practice , Dartmouth College;Dartmouth-Hitchcock Medical Center , Dartmouth Health

关键词: Healthcare quality improvement;    Paediatrics;    Patient-centred care;   

DOI  :  10.1136/bmjoq-2021-001736

学科分类：药学

来源: BMJ Publishing Group

【 摘 要 】

Background Preterm infants may remain in neonatal intensive care units (NICUs) to receive proper nutrition via nasogastric tube feedings. However, prolonged NICU stays can have negative effects for the patient, the family and the health system.Aim To demonstrate how a patient-centred, design thinking informed approach supported the development of a pilot programme to enable earlier discharge of preterm babies.Method We report on our design thinking-empathy building approach to programme design, initial outcomes and considerations for ongoing study.Results Through the use of design thinking methods, we identified unique needs, preferences and concerns that guided the development of our novel early discharge programme. We found that stable, preterm infants unable to feed by mouth and requiring nasogastric tubes can be cared for at home with remote patient monitoring and telehealth support. In addition, novel feeding strategies can help address parental preferences without compromising infant growth.Conclusion A patient-centred, design thinking informed approach supported the development of a pilot programme to enable earlier discharge of preterm babies. The programme resulted in a reduced length of stay, thereby increasing NICU bed capacity and limiting hospital turn-aways.

【 授权许可】

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