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

Abstract

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.

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

“…The Baby Bridge program was launched as a pilot program that billed for services provided to determine if costs could be offset by the income generated (Pineda et al, under review). The infrastructure for billing for therapy services through the Baby Bridge program already existed with the University affiliated with the study site due to other therapy programs.…”

“Always a Preemie”: Maternal Experiences Parenting a Very Preterm Infant into Toddlerhood

“…Home visiting programs may be particularly helpful. [54][55][56][57] Weekly in-home visits by a trained clinician can provide emotional support to families (including addressing parents' experience of trauma related to the NICU experience), aid in connecting with resources, and help parents to be able to best support the development and well-being of their children.…”

Factors related to enrolment in early therapy services following neonatal intensive care unit 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. By studying Baby Bridge programming enrolment, we aimed to isolate medical and sociodemographic factors related to early therapy services enrolment when system-related barriers to access are minimised.…”

“…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.…”