Perspectives and attitudes of pediatricians concerning post-discharge care practice of premature infants

Gad, Ashraf; E, Parkinson; Khawar, Nayaab; Elmeki, Amr; Narula, Pramod; Hoang, Danthanh

doi:10.3233/npm-1615

Cited by 15 publications

(12 citation statements)

References 20 publications

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“…Referrals for early therapy services are the standard of care for very preterm infants at NICU discharge in many communities within the United States (Barfield et al, 2008; Gad et al, 2017; Nwabara et al, 2017). Referrals for early therapy can be based not only on risk factors, such as low birth weight and cerebral injury, but also on identified functional limitations (Clements et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

“…There is evidence to support the need for and benefit of early therapy services (Athanasopoulou & Fox, 2014; Spittle et al, 2015; Stoffel & Schleis, 2014; Vergara et al, 2006; White-Traut et al, 2013), and it is considered the standard-of-care for high-risk infants after NICU discharge (Barfield et al, 2008; Gad et al, 2017; Nwabara et al, 2017). However, our team identified a significant gap in therapy services, with several infants who necessitated services not receiving them in a timely manner (Nwabara et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

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

Pineda

Heiny

Roussin

et al. 2020

Journal of Early Intervention

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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.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Pineda

Heiny

Roussin

et al. 2020

Journal of Early Intervention

View full text Add to dashboard Cite

show abstract

“…Although therapy referrals at NICU discharge are the standard of care in most NICU settings [15][16][17] and despite evidence supporting early therapy interventions and policy-mandated provision of services to at-risk infants [18], therapy is often difficult to access [19][20][21]. Preterm infants with neurodevelopmental impairment referred for therapy at the time of NICU discharge may wait an average of four to five months before they receive services [22].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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The aim of this project was to determine revenues and costs over time to assess the sustainability of the Baby Bridge program. MethodsThe Baby Bridge program was developed to promote timely, consistent and high quality early therapy services for high-risk infants following neonatal intensive care unit (NICU) discharge. Key features of the Baby Bridge program were defined as: 1) having the therapist establish rapport with the family while in the NICU, 2) scheduling the first home visit within one week of discharge and continuing weekly visits until other services commence, 3) conducting comprehensive assessments to inform targeted interventions by a skilled, single provider, and 4) using a comprehensive therapeutic approach while collaborating with the NICU medical team and community therapy providers. The Baby Bridge program was implemented with infants hospitalized in an urban Level IV NICU from January 2016 to January 2018. The number of infants enrolled increased gradually over the first several months to reach the case-load capacity associated with one full-time therapist by mid-2017. Costs of the therapists delivering Baby Bridge services, travel, and equipment were tracked and compared with claim records of participants. The operational cost of Baby Bridge programming at capacity was estimated based on the completed and anticipated claims and reimbursement of therapy services as a means to inform possible scale-ups of the program.

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“…As a result, preterm infants often receive therapy services in the NICU and are referred to physical therapy, occupational therapy and/or speech‐language pathology following discharge 6,7 . These early therapy services are considered the standard‐of‐care for infants with identified risk factors or alterations in function 8,9 …”

Section: Introductionmentioning

confidence: 99%

“…6,7 These early therapy services are considered the standard-of-care for infants with identified risk factors or alterations in function. 8,9 Early intervention (EI) programming is a common provider of early therapy following NICU discharge. In 1986, the US Department of Education implemented Part C of the Individuals with Disabilities Education Act (IDEA), providing therapy services for qualifying children from birth to age three.…”

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confidence: 99%

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

et al. 2020

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Aim Early therapy can improve developmental outcomes for preterm infants. However, preterm infants who are referred have low enrolment in early therapy services following neonatal intensive care unit (NICU) discharge. This manuscript aims to investigate the relationship between infant medical and sociodemographic factors and enrolment in early therapy services post‐NICU discharge, when system‐related barriers to access are minimised. Methods This was a retrospective investigation of 89 families with infants born ≤32 weeks of gestation. Families were approached for enrolment into early therapy services following NICU discharge through Baby Bridge programming, which aims to improve access to therapy services following NICU discharge. Results Seventy‐three (82%) families enrolled in early therapy services, and 16 (18%) families declined. Parents were more likely to enrol in early therapy if they had public insurance (P = 0.01), a maternal psychiatric diagnosis (P = 0.02) or additional children under 18 years in the home (P = 0.01). No infant medical factors were related to enrolment. Conclusion Although enrolment rates were high, 18% of families refused therapy services, despite removing system‐related barriers to access. Targeted interventions can be developed to increase enrolment in early therapy services among populations who are most likely to refuse therapy services after NICU discharge.

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Perspectives and attitudes of pediatricians concerning post-discharge care practice of premature infants

Cited by 15 publications

References 20 publications

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

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

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

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

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