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Published online November 1, 2006
PEDIATRICS Vol. 118 Supplement November 2006, pp. S115-S123 (doi:10.1542/peds.2006-0913H)
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ARTICLE


Evaluation and Development of Potentially Better Practices to Improve the Discharge Process in the Neonatal Intensive Care Unit

Debra C. Sims, RNCa, Jack Jacob, MDb, Marla M. Mills, RN, CNPc, Patricia A. Fett, APN/CNS, MSd, Gayle Novak, BSN, MA, RNe

a Newborn Intensive Care Unit
b Alaska Neonatology/Pediatrix Medical Group, The Children's Hospital at Providence, Anchorage, Alaska
c Newborn Intensive Care Unit, University of Minnesota Children's Hospital, Fairview, Minneapolis, Minnesota
d Newborn Intensive Care Unit, Rockford Memorial Hospital, Rockford, Illinois
e Department of Nursing Administration, St John's Hospital and Medical Center, Detroit, Michigan

Objective. Our goal was to identify potentially better practices that create a successful discharge planning process that spans the entire newborn intensive care stay to the next level of care by embedding the discharge planning into all aspects of patient care and communication.

Methods. Potentially better practices were developed through recommendations from a content expert and a literature review. Internal benchmarking, self-assessment tools, monthly conference calls, the Neonatal Intensive Care Quality Improvement Collaborative 2002 listserv, parent feedback, and semiannual conferences were used to finalize recommendations and implement practices.

Results. Potentially better practices included (1) create an easy-to-use/easy-to-access discharge planning tool kit, (2) restructure written and oral communication tools and processes to reflect plans for the day, the stay, and the way to discharge, (3) maximize the impact and use of caregiver educational tools, and update materials and delivery systems for caregiver education, (4) use continuous quality improvement tools and processes to ensure parent/caregiver and staff satisfaction, and (5) analyze and enhance transfers into and interactions with the community.

Conclusion. The potentially better practices are recommendations that are designed to integrate organizational, clinical, and operational processes to ensure optimal discharge planning from admission through follow-up in the community.

Key Words: discharge planning • potentially better practice • neonatal intensive care

Abbreviations: PBP—potentially better practice

Accepted Jul 18, 2006.


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