Barriers to the Implementation of Infant- and Family-Centered Developmental Care From Focus Groups With Neonatal Care
Jens Detollenaere1, Nadia Benahmed, Elena Costa
1Author Affiliations: Belgian Health Care Knowledge Centre (KCE), Brussels, Belgium (Drs Detollenaere, Costa, Van den Heede, and Christiaens and Ms Benahmed); Public Health School (Université Libre de Bruxelles), Brussels, Belgium (Ms Benahmed); and Leuven Institute for Healthcare Policy (KU Leuven), Leuven, Belgium (Dr Van den Heede).
Insights
Barriers to infant- and family-centered developmental care (IFCDC) in Belgian neonatal units include insufficient resources, limited knowledge access, and lack of management support. Addressing these is key for universal IFCDC implementation.
Area of Science:
- Neonatal care
- Healthcare implementation science
Background:
- Infant- and family-centered developmental care (IFCDC) is evidence-based but not universally adopted.
- Implementation varies across neonatal units, necessitating identification of specific barriers.
Purpose of the Study:
- To identify barriers to IFCDC implementation in Belgian neonatal care.
- To understand these barriers from the perspective of healthcare providers.
Main Methods:
- Conducted 8 online focus groups with 40 neonatal care providers.
- Utilized inductive thematic analysis with NVivo software.
Main Results:
- Identified barriers at contextual, hospital, and neonatal unit levels.
- Hospital/unit barriers: financing, staffing, infrastructure, knowledge access, learning climate, leadership, and IFCDC priority.
- Contextual barriers: peer pressure, partnerships, newborn/parent needs, external policy, and incentives.
Conclusions:
- Key barriers are resource availability (staffing, finance, infrastructure), accessible and updated knowledge, and supportive hospital management.
- Management support is crucial for an enabling climate, workflow compatibility, learning, and priority setting.
- Overcoming these barriers is essential for standardizing IFCDC in neonatal care.
Aim:
Although infant- and family-centered developmental care (IFCDC) is scientifically grounded and offered in many hospitals to some extent, it has not yet been universally implemented as the standard of care. In this article, we aim to identify barriers to the implementation of IFCDC in Belgian neonatal care from the perspective of neonatal care providers.
Methods:
We conducted 8 online focus groups with 40 healthcare providers working in neonatal care services. An inductive thematic analysis was carried out by means of Nvivo.
Results:
The focus groups revealed barriers related to contextual, hospital, and neonatal unit characteristics. Barriers found in the hospital and neonatal unit were related to financing, staffing, infrastructure, access to knowledge/information and learning climate, leadership engagement, and relative priority of IFCDC. Contextual barriers were related to peer pressure and partnerships, newborn/parent needs and resources, external policy, and budgetary incentives.
Conclusion:
Three main barriers to IFCDC implementation have been identified. Resources (staffing, financing, and infrastructure) must be available and aligned with IFCDC standards, knowledge and information have to be accessible and continuously updated, and hospital management should support IFCDC implementation to create an enabling climate, including compatibility with the existing workflow, learning opportunities, and priority setting.
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