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. 2022 Sep;6(1):e001581.
doi: 10.1136/bmjpo-2022-001581.

Multiprofessional cross-site working between a level 1 and a level 3 neonatal unit: a retrospective cohort study

Theodore Dassios  1   2 , Lucksini Selvadurai  3 , Ann Hickey  3 , Elizabeth Sleight  3 , Lisa Long  4 , Leonie Penna  4 , Vivette Wallen-Mitchell  3 , Ravindra Bhat  3 , Anne Greenough  5   6
Affiliations

Multiprofessional cross-site working between a level 1 and a level 3 neonatal unit: a retrospective cohort study

Theodore Dassios et al. BMJ Paediatr Open. 2022 Sep.

Abstract

Objective: To assess the association of short-term neonatal outcomes with cross-site working of multiple healthcare professional teams between a level 3 and a level 1 neonatal unit.

Design: Retrospective cohort study.

Setting: A level 1 neonatal unit in London.

Patients: All infants admitted to the neonatal unit, between 2010 and 2021.

Interventions: The clinical service was rearranged in 2014 with the introduction of cross-site working between the level 1 unit and a level 3 unit of neonatal doctors, nurses and allied healthcare professionals.

Main outcome measures: Admission of infants with a temperature less than 36°C, length of stay and time to first consultation by a senior team member.

Results: A total of 4418 infants were admitted during the study period. The percentage of infants delivered at a gestation below 32 weeks was higher in the pre-cross-site period (8.9%) compared with the cross site period (3.6%, p<0.001). The percentage of infants with an Apgar score less than 8 at 10 min was higher in the pre-cross-site period (6.2%) compared with the cross-site period (3.4%, p=0.001). More infants were admitted with a temperature less than 36°C in the pre-cross site period (12.3%) compared with the cross site period (3.7%, p<0.001). The median (IQR) duration of time to first consultation by a senior team member was higher in the pre-cross-site period (1 (0.5-2.6) hours) compared with the cross-site period (0.5 (0.2-1.3) hours) (p<0.001). The median (IQR) length of stay was 4 (2-11) days in the pre-cross-site period and decreased to 2 (1-4) days in the cross-site period (p<0.001).

Conclusions: Cross-site working was associated with lower rates of admission hypothermia, shorter duration of stay and earlier first senior consultation.

Keywords: Neonatology.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Length of stay (A), time to first consultation (B) and admission temperature (C) over the study period. The horizontal lines in the boxes represent the lower quartile, median and upper quartile values of the presented parameters and the whiskers the minimum and maximum values. The whiskers do not include the outliers, defined as values more than one and a half box lengths from the median which are presented as open circles. The whiskers do not include the extreme outliers, defined as values more than three box lengths from the median which are presented as asterisks.
See this image and copyright information in PMC

References

    1. NHS . Toolkit for high quality neonatal services. London, UK, 2009.
    1. Improvement NEaN . Implementing the recommendations of the neonatal critical care transformation review, 2019.
    1. BAPM . Service standards for hospitals providing neonatal care. 3rd Edition, 2010.
    1. Luu TM, Rehman Mian MO, Nuyt AM. Long-Term impact of preterm birth: neurodevelopmental and physical health outcomes. Clin Perinatol 2017;44:305–14. 10.1016/j.clp.2017.01.003 - DOI - PubMed
    1. Helenius K, Longford N, Lehtonen L, et al. Association of early postnatal transfer and birth outside a tertiary hospital with mortality and severe brain injury in extremely preterm infants: observational cohort study with propensity score matching. BMJ 2019;367:l5678. 10.1136/bmj.l5678 - DOI - PMC - PubMed

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