Inter-organizational pooling of NICU nurses in the Dutch neonatal network: a simulation-optimization study

Area of Science:

• Healthcare management
• Pediatrics
• Logistics

Background:

• Neonatal Intensive Care Units (NICUs) face capacity challenges, leading to high patient transport rates.
• Current high occupation levels in NICUs negatively impact care quality, patient safety, and family burden.
• Existing transport protocols for neonates are often undesirable and inefficient.

Purpose of the Study:

• To assess the potential of network collaboration strategies for reducing neonatal patient transports.
• To investigate the impact of flexible nurse deployment across NICUs to manage demand fluctuations.
• To optimize care delivery for premature and critically ill infants within a national network.

Main Methods:

• Development of a discrete event simulation model.
• Integration of an optimization module for shift allocation and transfer optimization.
• Case study analysis of the Dutch national NICU network (9 locations).

Main Results:

• Flexible capacity sharing can eliminate approximately 70% of patient transports with 15-50% sharing.
• Even with up to 15% capacity sharing in a main conurbation, about 35% of nationwide transports can be eliminated.
• Transporting staff instead of patients demonstrates significant potential for improving NICU network efficiency.

Conclusions:

• Network collaboration and flexible staff deployment are effective strategies to mitigate NICU capacity challenges.
• Implementing these strategies can significantly reduce the need for inter-center neonatal transports.
• Optimizing resource allocation can enhance the quality, safety, and efficiency of care for vulnerable neonates.