Introduction of Microsystems in a Level 3 Neonatal Intensive Care Unit

McMaster Children's Hospital200 enrolled

Overview

The advancement in life-saving technologies and clinical expertise in the care of extremely premature infants, have resulted in the development of large neonatal intensive care units (NICU). It has been suggested that reconstruction of megaunits of neonatal intensive care to smaller care units with specific patient population and clinical team providers will be essential to maintain optimal teamwork, quality of care and patient outcome. Despite the growing knowledge around the need for reconstruction of large NICUs to smaller units of care, there is no evidence regarding the safety and efficacy of microsystem model of care on the key aspects of health care. At the McMaster Children's Hospital (MCH), we planned a change from standard model of care to the microsystem model of care and therefore we aimed to prospectively assess the effect of this organizational change on the variable aspects of health care. A working group met weekly to formulate the implementation planning, to review the adaptation and adjustment process and to ascertain the quality of implementation following the initiation of the microsystem model. The study was retrospectively registered.

Study Type

OBSERVATIONAL

Enrollment

200

Conditions

Stress, Psychological Inflammatory Bowel Diseases Lung Diseases Infant Nutrition Disorders Eye Manifestations

Outcomes

Primary Outcomes

Change of stress level of Health Care Professional - Salivary cortisol (ng/dL)

Time frame: once every week, up to 3 month corrected age

Change of stress level of Parents - Salivary cortisol (ng/dL)

Time frame: once every week, up to 3 month corrected age

Change of stress level of Patients - Salivary cortisol (ng/dL)

Time frame: once every week, up to 3 month corrected age

Length of stay - days