Continuity Care Faculty Program

March 27, 2019 All families and babies admitted to the NICU endure significant stress, time away from home, uncertainty about the future, and much more. Families of babies in the NICU who are inpatients for longer than three months deal with these and other issues much longer than most. Over extended periods of time, and because of the natural flow of staff changes and physician service periods (every two weeks at the UPMC Children’s NICU), communications between families and providers also can become fragmented or inconsistent and can lead to stress and potential negative patient experiences.

In November 2018, at the suggestion of Thomas Diacovo, MD, chief of the UPMC Newborn Medicine Program, the UPMC Children’s NICU developed and instituted a new program for any family/patient unit who need stays on the NICU for longer than three months.

Dubbed the Continuity Care Faculty Program, every long-term NICU patient is assigned one physician who oversees the entirety of their care, regardless of whether or not the physician is assigned to be attending for a given week.

Carrie Rubino, MSN, RN, CCRN, and Diane Ankney, MSN, RN, NEA-BC, unit directors of the UPMC Children’s NICU, worked to implement the program and continue to oversee its elements.

Ms. Rubino and Ms. Ankney work to identify the patients who are or will be in need of greater than 90-day-stays, and coordinate with the physician staff who will be assigned to the patients.

“Our physicians work together to determine who will be the best fit to oversee care for
any particular patient, and we facilitate and help to coordinate all the necessary logistics. This includes holding a patient/family care conference at two-week intervals,” says Ms. Ankney.

These have become vitally important for family members in a short period of time. The families have access to a consistent voice who oversees the care of their baby, and the family is included in all of the communications and major decisions or plans. The conferences and single point of communication from one dedicated physician have been able to break down communication barriers, enhance communication with families, and enable a better understanding of family needs and the family’s understanding of the care their child is receiving or will need in the future.

“In terms of patient volume, we have approximately three or four of these longer-term NICU stays at any given time. And we try to limit the number of continuity cases that each physician has at one time to just two,” says Ms. Rubino.

Consistency of Communication Is Key to Family Satisfaction

The program was successful immediately upon implementation, ensuring communications to families from one team or physician to the next is seamless and consistent.

“Some of our patients are here for a long time — and oftentimes it is the families who know their babies best and can sense when something may be changing or an issue is arising. Valuing and respecting the parent’s insights and opinions is something that we work diligently on so the family understands that we value their input,” says Beverly Brozanski, MD, medical director of the NICU at UPMC Children’s.