O3296: Transport and NICCU Response to Delays in Mobilization for Critically Ill Neonates

Purpose/Objectives: To expedite care to vulnerable populations, US News and World Report have set a benchmark of 30-minute transport mobilization times for emergently ill neonatal patients. The team at a tertiary pediatric facility has implemented a quality improvement (QI) initiative to maintain this benchmark for emergent transfers into the facility. Data for 2018 showed compliance of 56%. In response to this, the transport physician was included in NICCU intake calls, and changes to the transport dispatch process were implemented. In 2019 and 2020, there was improvement and compliance exceeded the established benchmark at 82 and 84%. Due to challenges presented by the COVID pandemic, in 2021 and 2022, compliance fell short and mobilization times fell below the 80% benchmark at 78 and 77%, falling below this benchmark. The team implemented a 2-step intervention to reduce these transport mobilization delays: the introduction of a green-light system for patient acceptance and a pre-intake huddle with the NICCU physician, Transport physician, and NICCU charge nurse.

Design/Methods: The goal of this QI project is to reduce the time from patient acceptance to transport team mobilization and improve compliance with the established benchmark by US News and World Report. Using this established benchmark, published transport guidelines, and local consensus, interventions were developed with relevant stakeholder input for use at the institution and with transport team members. Intervention implementation with educational presentations, staff meeting follow-up, and monthly stakeholder QI meetings was completed with 42 transport team members (nurses, respiratory therapists, and physicians), the NICCU team, and 15 Access Center staff members from 2018 to 2023. Data were collected from electronic transport records and reviewed by a QI team of representatives from Transport, NICCU, and Access Center. The was metric measured was the percentage of emergent transports that met the 30-minute target for transport mobilization.

Results: In Sept 2022, the greenlight system was initiated. This alone did not improve compliance, so in December 2022, the team introduced a pre-intake huddle. Although the target goal was not reached in January 2023, February and March have seen improvement and have been above the goal at 91 and 87%.

Conclusion/Discussion: Data collection from post-implementation periods is ongoing. By October, data analysis into the implementation period should be completed and initial impacts on measured metrics will be better appreciated.