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Updated: Aug 14, 2025

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Multiprofessional cross-site working between a level 1 and a level 3 neonatal unit: a retrospective cohort study
Theodore Dassios1,2, Lucksini Selvadurai3, Ann Hickey3
1Neonatal Intensive Care Unit, King's College Hospital NHS Foundation Trust, London, UK theodore.dassios@kcl.ac.uk.
Objective:
To assess the association of short-term neonatal outcomes with cross-site working of multiple healthcare professional teams between a level 3 and a level 1 neonatal unit.
Design:
Retrospective cohort study.
Setting:
A level 1 neonatal unit in London.
Patients:
All infants admitted to the neonatal unit, between 2010 and 2021.
Interventions:
The clinical service was rearranged in 2014 with the introduction of cross-site working between the level 1 unit and a level 3 unit of neonatal doctors, nurses and allied healthcare professionals.
Main Outcome Measures:
Admission of infants with a temperature less than 36°C, length of stay and time to first consultation by a senior team member.
Results:
A total of 4418 infants were admitted during the study period. The percentage of infants delivered at a gestation below 32 weeks was higher in the pre-cross-site period (8.9%) compared with the cross site period (3.6%, p<0.001). The percentage of infants with an Apgar score less than 8 at 10 min was higher in the pre-cross-site period (6.2%) compared with the cross-site period (3.4%, p=0.001). More infants were admitted with a temperature less than 36°C in the pre-cross site period (12.3%) compared with the cross site period (3.7%, p<0.001). The median (IQR) duration of time to first consultation by a senior team member was higher in the pre-cross-site period (1 (0.5-2.6) hours) compared with the cross-site period (0.5 (0.2-1.3) hours) (p<0.001). The median (IQR) length of stay was 4 (2-11) days in the pre-cross-site period and decreased to 2 (1-4) days in the cross-site period (p<0.001).
Conclusions:
Cross-site working was associated with lower rates of admission hypothermia, shorter duration of stay and earlier first senior consultation.
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