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Improving infant outcomes through implementation of a family integrated care bundle including a parent supporting mobile application
  1. Jayanta Banerjee1,2,
  2. Annie Aloysius1,
  3. Karen Mitchell1,
  4. Ines Silva1,
  5. Dimitrios Rallis1,3,
  6. Sunit V Godambe1,
  7. Aniko Deierl1
  1. 1Department of Neonatology, Imperial College Healthcare NHS Trust, London, UK
  2. 2Department of Paediatrics, Imperial College London Institute of Clinical Sciences, London, UK
  3. 32nd Neonatal Unit, Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece
  1. Correspondence to Dr Jayanta Banerjee, Neonatology, Imperial College Healthcare NHS Trust, Queen Charlotte’s and Chelsea Hospital, London W12 0HS, UK; jayanta.banerjee{at}nhs.net

Abstract

Objective The aim of the Integrated Family Delivered Care (IFDC) programme was to improve infant health outcomes and parent experience through education and competency-based training.

Design In collaboration with veteran parents’ focus groups, we created an experienced co-designed care bundle including IFDC mobile application, which together with staff training programme comprised the IFDC programme. Infant outcomes were compared with retrospective controls in a prepost intervention analysis.

Main outcome measures The primary outcome measure was the length of stay (LOS).

Results Between April 2017 and May 2018, 89 families were recruited; 37 infants completed their entire care episode in our units with a minimum LOS >14 days. From a gestational age (GA) and birth weight-matched retrospective cohort, 57 control infants were selected. Data were also analysed for subgroup under 30 weeks GA (n=20).

Infants in the IFDC group were discharged earlier: median corrected GA (36+0 (IQR 35+0–38+0) vs 37+1 (IQR 36+3–38+4) weeks; p=0.003), with shorter median LOS (41 (32–63) vs 55 (41–73) days; p=0.022). This was also evident in the subgroup <30 weeks GA (61 (39–82) vs 76 (68–84) days; p=0.035). Special care days were significantly lower in the IFDC group (30 (21–41) vs 40 (31–46); p=0.006). The subgroup of infants (<30 weeks) reached full suck feeding earlier (median: 47 (37–76) vs 72 (66–82) days; p=0.006).

Conclusion This is the first reported study from a UK tertiary neonatal unit demonstrating significant benefits of family integrated care programme. The IFDC programme has significantly reduced LOS, resulted in the earlier achievement of full enteral and suck feeds.

  • neonatology
  • multidisciplinary team-care
  • information technology
  • health services research
  • health economics
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Footnotes

  • Contributors JB and AD: conceptualised and co-led the programme and developed the study design. JB: wrote the first draft and reviewed and revised the manuscript. KM, IS, AA, SVG and AD: reviewed and revised the manuscript. DR: performed statistical analysis and reviewed and revised the manuscript. All authors approved the final manuscript and agree to be accountable for all aspects of the work.

  • Funding The Integrated Family Delivered Care quality improvement project was funded by the Imperial Health Charity grant reference number 161728 and 171824. The authors have no financial relationships relevant to this article todisclose. KP and IS were employed through the grant but none of the other authors had financial relationship with the charity or the fund.

  • Competing interests None declared.

  • Ethics approval The programme and the mobile application received approval from the local Audit and Information Governance monitoring committee at the Imperial College Healthcare NHS Trust.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Not required.

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