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RESEARCH TRIANGLE PARK, N.C. — Researchers at RTI International, a nonprofit research institute, and George Mason University (GMU), have published a new commentary in the Lancet in response to a recent study of innovative approaches for neonatal intensive care unit (NICU) patients. The study showed that “bundled” approaches to NICU care —those that formally include specialists along with physicians —yield better care results than the traditional model, which relies on physicians to build collaboarations themselves, if at all.
The study, conducted across 5953 patients in the NICUs of 12 French hospitals, strongly suggests the need for structured protocols on collaboration across a range of healthcare providers.
“After reviewing the study, we found that there is immense potential for low-cost improvements to healthcare delivery by incorporating a bundled approach to care in the NICU,” said Abhik Das, a Distinguished Fellow in Biostatistics at RTI and co-author on the commentary. “Although there are many reviews of quality improvement initiatives in the NICU, this study was the first to use a stepped-wedged approach, an approach that reduces bias and can be more accurate and acceptable.”
The commentary, co-authored by Das and Rosemary D. Higgins, senior associate dean for research in the College of Human Health Services at GMU, highlighted study strengths; it was the first stepped-wedged study of neonatal intensive care units (NICUs) to compare bundled and traditional approaches to NICU care. This method assigns hospitals to treatment at different times instead of simultaneously, generally reduces bias, improves statistical efficiency, and controls for more complex factors than a traditional randomized trial.
Das and Higgins also noted from the findings that safety education for NICU care providers is essential and that the results of the study indicated that care providers could benefit from additional educational trainings and interventions.
“This is really a new field in serious need of further research. This study drew on NICUs in France, a country with a much more centralized and homogeneous healthcare system than the United States,” said Das. “We would need to see how these two approaches, traditional and bundled, fare in a setting with multiple for-profit healthcare providers. The US system is much more complex.”
To read the full commentary, click here.
