Implementation of the Baby Bridge Program Reduces Timing Between NICU Discharge and Therapy Activation

Abstract

The Baby Bridge program was developed to ensure timely and continuous therapy services following neonatal intensive care unit (NICU) discharge. A systematic process for development of the Baby Bridge program included a review of the evidence, integration of theory, and input from NICU health care professionals, early intervention leadership, and parents of preterm infants. Using the Consolidated Framework for Implementation Research, we aimed to (a) assess organizational readiness for the new programming; (b) determine adoptability, acceptability, and fidelity following implementation; and (c) evaluate the program. Following the development of Baby Bridge programming, readiness for implementation was observed at the study site. Baby Bridge programming was adopted by the team, acceptable to health care staff and parents, achieved the key features defined, and resulted in more infants born ≤30 weeks receiving early therapy services ( n = 58/60, 97% compared with n = 44/57, 77%; p < .0001) an average of 85 days earlier, p < .0001, β = −84.7 (–70.2 to −99.2), than historical controls.

Factors related to enrolment in early therapy services following neonatal intensive care unit discharge

“…This possibility is supported by the fact that some surveyed families reported Baby Bridge programming helped their infant find and receive the therapy they needed and that the programme helped families learn to communicate with EI and other health care providers about their child. 21 Our study found that mothers with a psychiatric diagnosis in the DSM-5 were significantly more likely to enrol their infants in early therapy services following NICU discharge. To our knowledge, only one other article has specifically examined maternal mental health and participation in EI services.…”

“…Baby Bridge programming, in which a single provider met with the family prior to NICU discharge, provided interim therapy services in the home and facilitated the transition to EI, may have assisted larger families with overcoming some of the practical barriers which can limit enrolment. This possibility is supported by the fact that some surveyed families reported Baby Bridge programming helped their infant find and receive the therapy they needed and that the programme helped families learn to communicate with EI and other health care providers about their child 21 …”

“…18 Baby Bridge programming was designed, in part, to decrease some of these barriers to accessing early therapy services following NICU discharge. Details regarding features of the Baby Bridge programme which were implemented to minimise barriers to access are discussed in Pineda et al 21 By assessing enrolment of families to this programme, we were able to examine factors related to enrolment in early therapy services following NICU discharge when system-related barriers to access were minimised. Identifying these factors allows for the development of targeted interventions and system improvements to optimise enrolment in early therapy services.…”

“…The Baby Bridge programme has been related to improved access and reduced time to therapy initiation following NICU discharge. 21 Further investigation revealed it to be a sustainable programme when nestled within existing organisational infrastructure. 22 However, despite the guided enrolment process, and provision of timely and consistent therapy services with Baby Bridge programming, some families continue to decline early therapy services for their infants.…”

The Baby Bridge program: A sustainable program that can improve therapy service delivery for preterm infants following NICU discharge

“…Previous work has demonstrated improvements in access to early therapy services with Baby Bridge programming [33]. This previous work demonstrated that Baby Bridge programming was an effective implementation strategy and was feasible to implement.…”