Bardach SH, Perry AN, Kapadia NS, Richards KE, Cogswell LK, Hartman TK. Redesigning care to support earlier discharge from a neonatal intensive care unit: a design thinking informed pilot.
BMJ Open Qual 2022;
11:bmjoq-2021-001736. [PMID:
35613830 PMCID:
PMC9134166 DOI:
10.1136/bmjoq-2021-001736]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 05/11/2022] [Indexed: 11/22/2022] Open
Abstract
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.
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