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Impact of a dedicated neonatal stabilization room and process changes on stabilization time
S Shivananda1, S Gupta1, S Thomas1
1Division of Neonatology, Department of Pediatrics, McMaster University, Hamilton, ON, Canada.
Insights
Implementing a dedicated resuscitation and stabilization (RAS) room and optimizing processes significantly reduced infant stabilization time. This quality improvement initiative enhanced care efficiency for preterm infants without impacting illness severity or morbidity.
Area of Science:
- Neonatal care
- Quality improvement science
- Clinical process optimization
Background:
- Infant stabilization is critical for preterm neonates.
- Existing processes may lead to delays in critical care.
- Optimizing the resuscitation and stabilization (RAS) environment is essential.
Purpose of the Study:
- To assess the impact of a dedicated RAS room and process modifications on infant stabilization duration.
- To evaluate changes in infant illness severity and morbidity post-intervention.
Main Methods:
- Prospective quality improvement study in a tertiary care center.
- Implementation of a dedicated RAS room, preresuscitation huddles, equipment pairing, and enhanced documentation.
- Primary outcome: median time to stabilization. Secondary outcomes: Day 1 illness severity and discharge morbidity.
Main Results:
- Sustained reduction in median stabilization time from 90 to 72 minutes.
- Decreased time for procedure completion.
- Illness severity and morbidity remained unchanged.
Conclusions:
- A dedicated RAS room combined with process improvements enhances care efficiency.
- The integrated approach streamlines critical care delivery for neonates.
- This model demonstrates successful quality improvement in neonatal resuscitation.
Objective:
Our objective was to evaluate the impact of a dedicated resuscitation and stabilization (RAS) room and process changes on infant stabilization time.
Study Design:
A prospective quality improvement study was conducted on preterm infants in a tertiary care center. A dedicated RAS room, preresuscitation huddle, infant-isolette-ventilator pairing and improved documentation were implemented. The primary outcome was median time to stabilization and secondary outcomes were illness severity on day 1 and morbidity at discharge.
Results:
A sustained reduction in median time to stabilization from 90 min in the preimplementation phase to 72 min in the sustainability phase was observed. All planned and iterative process changes were integrated into the RAS team's daily routine. Time to completion of procedures decreased, illness severity and morbidity remained unchanged.
Conclusion:
A dedicated RAS room adjacent to the delivery suite in conjunction with process changes improves efficiency of care.
