Assuring safe patient care in a level III NICU in anticipation of hospital closure

J Perinatol. 2020 Nov;40(11):1719-1725. doi: 10.1038/s41372-020-0648-7. Epub 2020 Mar 17.

Abstract

Objectives: Hospital closures promote latent factors putting patients at risk for medical errors. Our goal was to maintain safe patient care in our Neonatal Intensive Care Unit (NICU) by preventing any increase in neonatal mortality or hospital-based complications prior to hospital closure.

Methods: Interventions included expanding TeamSTEPPS huddles and Leadership WalkRoundsTM. Measurements of safety domains were conducted using the Safety Attitudes Questionnaire. A run chart tracked neonatal mortality. We compared hospital-based complications for all neonatal admissions in 2019 with our own past outcomes.

Results: Teamwork climate scores increased from an average score of 24.6-28.3 (maximum score 30, P < 0.05, CI 6.7-0.9). Quarterly neonatal mortality and neonatal outcomes did not worsen. The frequency of transfer did not increase.

Conclusions: A strong teamwork climate with resilient leadership may mitigate safety concerns under calamitous circumstances.

MeSH terms

  • Health Facility Closure*
  • Humans
  • Infant
  • Infant Mortality
  • Infant, Newborn
  • Intensive Care Units, Neonatal*
  • Medical Errors
  • Patient Care*
  • Patient Safety*