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Margaret Everett
Pronouns
She/Her/Hers
Job Title
Neonatologist
Academic Rank
Instructor
Department
Pediatric Newborn Medicine
Authors
Rohini Shikhare, Margaret Everett
Principal Investigator
Margaret Everett
Research Category: PCERC/Health Policy/Outcomes
Tags
The BWH NICU had no routine family meetings, causing stress and confusion among families of critical ill babies. BWH is a member of the Neonatal Quality Improvement Consortium of the Level 2-4 SCN/NICUs in MA (NEOQIC) on a specific NEOQIC Family Engagement Initiative. BWH NICU started a QI Project of for premature babies born at a gestational age < 33 weeks. We initiated a process to schedule and provide a Multi-disciplinary Family Engagement Meeting before a baby’s day of life 7, including the appropriate use of interpreters. The Multi-disciplinary team included the baby’s Family, the Attending Neonatologist or NNP/PA, a NICU Social Worker, and the bedside RN (Primary RN if available), often a NICU Fellow or Resident Physician, and often other NICU team members. The Multi-disciplinary Family Engagement Meetings had a template to facilitate caregivers’ ability to provide consistent communication, including the appropriate use of interpreters. A QI team (multi-disciplinary) met regularly to improve the process. Before starting the project, BWH NICU conducted Multi-disciplinary Family Meetings about for about 8% of babies before rolling out the QI project on July 17, 2021. The goal was to improve to 50% in 6 months. Using QI techniques, there was improvement to 58% by March 31, 2022. Further QI team meetings created PDSA steps which resulted in improvement to 81% in 4 months by July 31, 2022. We are moving towards the implementation phase of QI as families feel more welcome and engaged as a result of the Family Engagement meetings.
The BWH NICU had no routine family meetings, causing stress and confusion among families of critical ill babies. Families are often over-whelmed by the monitors and alarms, feel unsure of their place in their baby’s care, and unaware of the method to receive medical updates. The BWH NICU is a member of the Neonatal Quality Improvement Consortium of the Level 2 SCNs and Level 3-4 NICUs in MA (NEOQIC). As part of a NEOQIC Family Engagement Initiative, BWH NICU started a Quality Improvement (QI) Project for babies born prematurely at a gestational age of less than 33 weeks. We initiated a process to schedule and provide a Multi-disciplinary Family Engagement Meeting before a baby’s day of life 7. The Multi-disciplinary team included the baby’s Family, the Attending Neonatologist or NNP/PA, a NICU Social Worker, and the bedside RN (Primary RN if available), often a NICU Physician Trainee, and often other NICU team members. The Multi-disciplinary Family Engagement Meetings had a template to facilitate caregivers’ ability to provide consistent communication, including the appropriate use of interpreters. We learn about the family and their unique situation and needs, explain the current medical status and anticipated future course, welcome the family as an essential part of the medical team including how to engage with their baby, describe the medical team and how the team works together, develop personalized communication methods, and answer the family’s questions. There were regularly scheduled Multi-disciplinary QI team meetings, where we reviewed the data and developed improvements to the process of scheduling and developed ways to make the meetings easier for families and providers. Before starting the project, BWH NICU conducted Multi-disciplinary Family Meetings about for about 8% of babies before rolling out the QI project on July 17, 2021. Our original goal was to improve to 50% in 6 months. Using QI techniques, there was initial improvement from 8% to 58% by March 31, 2022. Further quality improvement meetings led to steps that resulted in improvement to 81% in 4 months by July 31, 2022. We are moving towards standard implementation of providing Multi-disciplinary Family Engagement Meetings by DOL 7 for families who have babies born prematurely at less than 33 weeks to make the NICU a welcome place for all families.
