Journal
ACADEMIC PEDIATRICS
Volume 21, Issue 7, Pages 1244-1252Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.acap.2021.03.007
Keywords
telemedicine; pediatric; neonatology; patient-centered care; clinical rounds
Categories
Funding
- University of California Davis Center for Healthcare Policy and Research
- National Center for Advancing Translational Sciences, National Institutes of Health [UL1 TR001860, KL2 TR001859]
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health [K23HD101550]
- University of California Davis Center for Health Technology
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The virtual family-centered rounds (FCR) intervention in neonatal intensive care unit shows feasibility, but recruitment and intervention uptake rates need improvement. Feasibility objectives related to technical issues, burden, and data collection were achieved, indicating potential for improving patient and caregiver outcomes.
OBJECTIVES: To measure the feasibility, reach, and potential impact of a virtual family-centered rounds (FCR) intervention in the neonatal intensive care unit. METHODS: We conducted a randomized controlled pilot trial with a 2:1 intervention-to-control arm allocation ratio. Caregivers of intervention arm neonates were invited to participate in virtual FCR plus standard of care. We specified 5 feasibility objectives. We profiled intervention usage by neonatal and maternal characteristics. Exploratory outcomes included FCR caregiver attendance, length of stay, breast milk feeding at discharge, caregiver experience, and medical errors. We performed descriptive analyses to calculate proportions, means, and rates with 95% confidence intervals (CI). RESULTS: We included 74 intervention and 36 control subjects. Three of the five feasibility objectives were met based on the point estimates. The recruitment and intervention uptake objectives were not achieved. Among intervention arm subjects, recruitment of a caregiver occurred for 47 (63.5%, 95% CI 51.5%-74.4%) neonates. Caregiver use of the intervention occurred for 36 (48.6%, 95% CI 36.8%-60.6%) neonates in the intervention arm. Feasibility objectives assessing technical issues, burden, and data collection were achieved. Among the attempted virtual encounters, 95.0% (95% CI 91.5%-97.3%) had no technical issues. The survey response rate was 87.5% (95% CI 78.2%-93.8%). Intervention arm neonates had 3.36 (95% CI 2.66%-4.23) times the FCR caregiver attendance rate of subjects in the control arm. CONCLUSIONS: A randomized trial to compare virtual FCR to standard of care in neonatal subjects is feasible and has potential to improve patient and caregiver outcomes.
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