Published online November 1, 2006
PEDIATRICS Vol. 118 Supplement November 2006, pp. S95-S107 (doi:10.1542/peds.2006-0913F)
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ARTICLE


Development and Dissemination of Potentially Better Practices for the Provision of Family-Centered Care in Neonatology: The Family-Centered Care Map

Michael S. Dunn, MDa, Maureen C. Reilly, RRTa, Anne M. Johnston, MDb, Robert D. Hoopes, Jr, RNC, BSNc and Marie R. Abraham, MAd

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

OBJECTIVE. Family-centered care has become integral to the provision of quality neonatal intensive care. However, practices that reflect the core principles of family-centered care have not been described fully in the literature or implemented and evaluated consistently within newborn intensive care. The objective of this study was to create a family-centered care map that enhances the ability of the health care team to work with families to coordinate and deliver care in a holistic manner to meet the developmental, physical, and psychosocial needs of NICU patients and their families.

METHODS. Potentially better practices were developed for sequential clinical phases by using standardized methods. These included focus groups with families, brainstorming sessions with staff, literature review, and input from established family advisory groups and family-centered care experts. Potentially better practices then were integrated into the family-centered care map that was configured in a Web-based format. Overall utility will be evaluated by determining the effect of the family-centered care map on length of stay, parental satisfaction, and family-centered care beliefs and practices among NICU staff.

RESULTS. Sixty-three potentially better practices were identified for 7 clinical phases and 3 variations that were believed to characterize the clinical course of a typical NICU patient. A prototype of the Web-based family-centered care map that illustrates the clinical phases with links to the related potentially better practices, operational processes, and case studies was created. Baseline data from a care provider survey, from a family satisfaction survey, and on length of stay have been collected.

CONCLUSIONS. Quality improvement methods and collaboration among 3 centers led to the development of an innovative Web-based resource to assist individual care providers and family advisors to provide comprehensive family-centered care to infants and families. Implementation of the family-centered care map has potential to affect positively the quality of newborn intensive care and lead to improved long-term outcomes.

Key Words: family-centered care • family involvement • decision-making • families as advisors • family advisory council • collaborative quality improvement • newborn intensive care

Abbreviations: FCC—family-centered care • VON—Vermont Oxford Network • PBP—potentially better practices • NIC/Q 2002—Neonatal Intensive Care Quality Improvement Collaborative 2002

Accepted Jul 18, 2006.


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