Integrated care pathways: a tool to improve infant monitoring in a neonatal unit

Area of Science:

• Neonatal care
• Healthcare quality improvement
• Clinical pathway implementation

Background:

• Integrated care pathways (ICPs) are structured tools designed to standardize patient care by prompting for key observations and interventions.
• The implementation of ICPs in resource-limited settings requires evaluation to assess their impact on clinical practice.

Purpose of the Study:

• To evaluate the effectiveness of introducing integrated care pathways (ICPs) in a neonatal department in Malawi.
• To assess the impact of ICPs on the completeness of recorded patient observations.

Main Methods:

• A comparative study analyzing the percentage of recorded neonatal observations before and after the introduction of ICPs.
• Data collection spanned one year prior to ICP implementation and two years post-implementation at Queen Elizabeth Central Hospital, Blantyre.

Main Results:

• The introduction of ICPs led to a significant increase in recorded observations, from 0-33% to 9-96% of possible daily observations.
• A slight decrease in some observations was noted in the second year, potentially due to staff shortages, indicating a need for sustained support.

Conclusions:

• Integrated care pathways (ICPs) are effective and user-friendly tools for improving neonatal care delivery in resource-limited settings.
• Adapting ICPs to local needs is crucial for their successful integration and sustained impact on patient care.