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Redesigning care to support earlier discharge from a neonatal intensive care unit: a design thinking informed pilot

Shoshana H Bardach1, Amanda N Perry2, Nirav S Kapadia2,3

  • 1The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, New Hampshire, USA shani.bardach@dartmouth.edu.

BMJ Open Quality
|May 25, 2022
PubMed

Insights

A new pilot program using design thinking enables earlier discharge for preterm infants needing nasogastric tube feeding. This approach supports home care with remote monitoring, improving infant growth and reducing NICU stays.

Area of Science:

  • Neonatal care
  • Pediatric health outcomes
  • Healthcare innovation

Background:

  • Prolonged neonatal intensive care unit (NICU) stays are common for preterm infants requiring nasogastric tube feeding.
  • Extended NICU care presents challenges for patients, families, and healthcare systems.

Purpose of the Study:

  • To demonstrate a patient-centered, design thinking approach for developing an early discharge program for preterm infants.
  • To facilitate earlier hospital discharge for preterm neonates while ensuring adequate nutritional support.

Main Methods:

  • Employed a design thinking and empathy-building methodology for program development.
  • Focused on identifying and addressing unique needs, preferences, and concerns of families.
  • Incorporated remote patient monitoring and telehealth for home-based care.

Main Results:

  • Developed a novel early discharge program for stable preterm infants unable to feed orally.
  • Demonstrated that infants can be safely cared for at home with remote support and modified feeding strategies.
  • Observed that novel feeding strategies accommodated parental preferences without hindering infant growth.

Conclusions:

  • A patient-centered, design thinking approach successfully facilitated the development of a pilot early discharge program.
  • The program led to a reduced length of stay in the NICU.
  • Early discharge initiatives can enhance NICU bed capacity and reduce hospital diversions.
Abstract

Keywords:
Healthcare quality improvementPaediatricsPatient-centred care

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