Published online November 1, 2006
PEDIATRICS Vol. 118 Supplement November 2006, pp. S108-S114 (doi:10.1542/peds.2006-0913G)
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ARTICLE


Implementation and Case-Study Results of Potentially Better Practices for Family-Centered Care: The Family-Centered Care Map

Anne M. Johnston, MDa, Candice E. Bullock, RNC, BAa, Jean E. Graham, RN, BAa, Maureen C. Reilly, RRTb, Colleen Rocha, RNb, Robert D. Hoopes, Jr, RNC, BSNc, Vanessa Van Der Meid, RN, BSNc, Susan Gutierrez, RNC, BSNc and Marie R. Abraham, MAd

a Vermont Children's Hospital at Fletcher Allen Health Care and Department of Pediatrics, University of Vermont, Burlington, Vermont
b Sunnybrook and Women's College Health Sciences Centre and Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
c Joe DiMaggio Children's Hospital, Hollywood, Florida
d Institute for Family-Centered Care, Bethesda, Maryland

Objective. The objective of this study was to enhance the ability to coordinate and deliver care in a holistic manner, through a family-centered care map, so that the developmental, physical, and psychosocial needs of the infant and family are met.

Methods. A Web-based map was based on 7 distinct clinical phases with 3 variations of an infant's course through a NICU. Sixty-three potentially better practices were identified and 7 potentially better practices were implemented through case studies.

Results. Measures of family satisfaction revealed improvements in delivery of family-centered care. Increases in discharge growth parameters for extremely low birth weight infants were demonstrated. Length of stay for very low birth weight infants decreased from 73 to 60 days in Vermont.

Conclusions. The collaborative process enhances identification of potentially better practices and results in both qualitative and quantitative improvements in family-centered care.

Key Words: family-centered care • care map • very low birth weight infants • quality improvement

Abbreviations: FCC—family-centered care • LOS—length of stay • VON—Vermont Oxford Network • PBP—potentially better practice • NIC/Q 2002—Neonatal Intensive Care Quality Improvement Collaborative 2002 • SWC—Sunnybrook and Women's Health Sciences Centre • JDCH—Joe DiMaggio Children's Hospital • VCH—Vermont Children's Hospital at Fletcher Allen Health Care • ELBW—extremely low birth weight

Accepted Jul 18, 2006.