Implementing team-based newborn well care: Perspectives of nurses and physicians

Area of Science:

• Pediatric primary care
• Healthcare redesign
• Clinical workflow optimization

Background:

• Pediatric primary care redesign involves significant changes to clinical teams and workflows.
• Understanding clinician perspectives is crucial for successful implementation of these changes.

Purpose of the Study:

• To describe pediatric clinicians' perspectives on their experiences with a primary care redesign initiative.
• To explore clinician views on a pilot newborn care redesign (NBH) at a pediatric primary care site.

Main Methods:

• Qualitative study using semi-structured interviews with 17 clinicians (physicians, RNs, nurse practitioner).
• Interviews guided by the Consolidated Framework for Implementation Research.
• Data analyzed using an integrated coding approach.

Main Results:

• Clinicians reported NBH implementation was facilitated by agreement on existing challenges and interest in optimizing RN roles.
• NBH was perceived to enhance teamwork, mitigate unpredictability, and improve staff satisfaction.
• Barriers included staffing constraints and concerns about task sharing impacting patient relationships and continuity.

Conclusions:

• Redesign initiatives focusing on task sharing between RNs and physicians can foster teamwork and manage clinical unpredictability.
• Further clarification on redesign's impact on patient continuity and trust, alongside optimal staffing, is needed for successful adoption.