Building a Neonatal Neurocritical Care Program: A Practical Guide to Initial Implementation

Although neonatal neurocritical care (NNCC) programs have existed for decades and have been linked to improved outcomes in high-risk neonates, relatively few institutions have these models in place, and guidance on program development is limited. Designing am NNCC program includes the following: (1) targeting high-risk clinical populations such as infants with hypoxic-ischemic encephalopathy, seizures, and posthemorrhagic hydrocephalus, (2) collaborating with multidisciplinary team members, (3) ensuring availability of equipment to collect key clinical information, including electroencephalograms, cranial ultrasounds, and brain magnetic resonance imaging scans, (4) developing evidence-based pathways, and (5) prioritizing access to follow-up care after discharge. Program implementation requires a needs assessment, financial planning, onboarding and training, and ongoing quality improvement efforts. Importantly, the program should align with parental values and expectations for their child's care. Furthermore, after establishing clinical neurocritical care services, the program can strategically expand to encompass additional clinical pathways, comprehensive formal specialized training, and innovative research opportunities.