TORONTO, ONTARIO--(Marketwired - Feb. 10, 2014) - Three years after Sunnybrook's Neonatal Intensive Care Unit (NICU) moved from an open bay design to a single-family room (SFR) model of care, a new study has found significant improvements in clinical, operational and satisfaction outcomes.
"Moving to a new NICU allowed us to study staff and parent satisfaction in two very differently designed units," says Dr. Jo Watson, Operations Director, Women & Babies Program at Sunnybrook Health Sciences Centre and principle investigator. The study measured staff quality of work life and family satisfaction three times between April 2010 and September 2011: six months before the move, and six months and one year after the move.
"There were improvements in all areas of measurement, including staff and family satisfaction. The design of the new NICU also reduced medication errors, nosocomial infections, and lowered costs per patient day by $500," says Watson.
The open bay design of Sunnybrook's former NICU allowed only 40 square feet of space per baby, with 12 babies cared for in one room. The new 48-bed unit has 120 square feet of space per baby, and the unit is the only SFR model in a Level III NICU in Ontario. "The original NICU was built in the early 1980s, when open bay design was considered the optimal way to provide intensive care to infants," says Marion De Land, NICU Patient Care Manager and co-author of the study. "Unit environment is now recognized as an important element of care. The design of our new NICU reflects that change in practice."
While previously conducted studies at other NICUs found a drop in staff satisfaction after moving to an SFR model, Watson and her colleagues found the opposite. At six months and one year post-move, significant improvements were noted by staff in areas such as quality of work environment, noise level, staff and parental privacy, ease of communication, and ability for parents to contribute to their babies' care. One year post-move, staff also reported improvements in their ability to interact with parents, productivity and staff morale.
"When we moved to the SFR model, some staff members were concerned about decreased ability to visualize both their patients and other team members. We found other ways to bring staff together and promote communication, such as daily rounds, teaching sessions, a staff lounge and the ability to contact team members through a voice-activated system," says Watson.
One year after the move, parents reported improvements in privacy, confidence in feeding and comforting their baby, adjusting to having their baby home, and being less bothered by feelings of sadness or irritability.
An important part of creating a positive parent experience was the hiring of a parent coordinator shortly after the move. Kate Robson, a veteran NICU parent herself, encourages families to participate in programmed group activities and events, and this may have helped families feel less isolated and stressed in the new, SFR unit.
"Family-centred, developmentally supportive care is at the core of the design of the new NICU," says Robson, who is also a co-author of the study. "When parents and families feel more comfortable in the unit and more comfortable caring for their babies, it makes all the difference."
The results of the study were presented on February 8 at the Gravens Conference.