Identifying and Mitigating Health Disparities Following a Neonatal Intensive Care Unit (NICU) Design Change from Open Bay to Single Family Rooms

新生儿重症监护病房 (NICU) 设计从开放式病房改为单户家庭病房后，确定并减轻健康差异

• 批准号: 10672384
• 负责人: Stephanie Teixeira-Poit
• 金额: $ 14.22万
• 依托单位: NORTH CAROLINA AGRI & TECH ST UNIV
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10672384
• 关键词: Admission activity; African American student; Anecdotes; Area; Attention; Black race; Caring; Child Health; Communities; Cone; Data; Data Analyses; Data Collection; Decision Making; Development; Disadvantaged; Economics; Ensure; Environment; Ethnic Origin; Evaluation; Family; Frequencies; Health; Health system; Historically Black Colleges and Universities; Inequality; Interview; Latinx; Learning; Lighting; Literature; Low income; Maternal and Child Health; Medical; Methods; Mothers; Needs Assessment; Neonatal Intensive Care Units; Newborn Infant; Noise; Nurses; Outcome; Parents; Patient Care Team; Patients; Perception; Policies; Premature Birth; Procedures; Process; Quality of Care; Race; Recommendation; Reduce health disparities; Research; Review Literature; Safety; Sensory Deprivation; Socioeconomic Status; Structure; Students; Surveys; Time; Transportation; Woman; Workload; care delivery; community engagement; design; disparity reduction; experience; graduate school; health care delivery; health disparity; improved; job market; neonate; patient subsets; professional students; racial disparity; skills; social health determinants; trend

Project Abstract With over 400,000 preterm births in the US annually, neonatal intensive care units (NICUs) are critical to providing high quality care and ensuring optimal health outcomes for neonates. Neonatal intensive care units (NICUs) began as open-bays (large rooms, variable size, and multiple newborns admitted), but the latest NICU design and a growing trend is single family rooms that typically have only one baby admitted per room and accommodate at least one parent rooming-in. The scholarly literature provides mixed- evidence on the impact of NICU design changes on patient health outcomes and patient experience of care. Also, a recent community needs assessment called to reduce disparities in maternal and child health by race and ethnicity. These lead us to conduct a mixed-methods process and outcome evaluation examining the impact of a NICU transition from open bay to single family rooms that occurred at Cone Health in Greensboro, NC. A theoretical benefit of single family room designs is increased parent-neonate bonding time, yet this assumes that parents routinely room-in with neonates. Black and low income parents may experience economic and transportation hardships that constrain their opportunity to room-in at the frequency of white and economically privileged parents. Thus, we hypothesize that single family rooms disproportionately benefit neonates from economically privileged families (predominantly white) compared to neonates from families with low incomes (predominantly Black and LatinX in our community). We will conduct a mixed-methods study that triangulates patient health outcome data, patient experience surveys, and in-depth interviews with NICU staff to explore whether different patient sub-populations unequally benefited from or were unintentionally harmed by a NICU design change from open-bay to single family rooms. A secondary data analysis will help us determine whether patient health outcomes and patient experience of care changed before vs. after the NICU transition from open-bay to single family rooms. We will examine health disparities across patient sub-populations, with special attention to race/ethnicity and socioeconomic status. We will then collect and analyze qualitative data to provide rich detail on processes that reproduce health disparities; we will explore barriers and facilitators to implementing strategies to mitigate unintended consequences, improve care delivery, improve health outcomes, and reduce health disparities among patient sub- populations. Using a community engaged approach with a Stakeholder Advisory Board, we will develop a conceptual framework on the impact of NICU design changes and disseminate lessons learned and actionable recommendations to drive systemic changes to policies and procedures at health systems to improve patient quality of care, improve health outcomes, and reduce health disparities.

项目摘要