1. Rising Stars
Improving Communication in the NICU
Geraldine Base, RNC, MSN/MPH
CNIII, NICU
Cedars-Sinai Medical Center
Ellen Mack, RNC, CNS, MN
Yvonne Kidder, RNC, MSN

2. Topic:
 Feedback from parents and nurses revealed that there are gaps in communication when it comes to
receiving updates, setting goals, changes to the plan of care and discharge teaching for their infants.
Aim/Question/Objective Statement:
 Will a daily nurse driven phone call that provides the parents with an update on the plan of
care/changes, improve patient satisfaction and the efficiency of the discharge process?
 Are there specific information that parents want to know that will decrease their anxiety and increase
their trust in the healthcare team?
 By providing parents real time updates on their infant’s plan of care, patient satisfaction score
(communication with health care team Nurses-81.5% MD-83%) will improve 10% by April 2016.
Topic Overview

3. Background
Project Reason/Rationale:
Parents in the NICU are anxious and feel powerless regarding their infant’s condition and they’re
reliant on the healthcare team to provide them with updates. Infants in the NICU stay anywhere from
24H to months. Parents become frustrated when the plan of care or goals change and they are not
made aware.
Relevancy:
Parents are the main care givers for these infants and when they are not updated on changes they
distrust their healthcare team and are not prepared for discharge resulting in low patient satisfaction
scores.
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4. Literature Review
Literature/Best Practice Support
Healthcare Provider to Parent “communication” has been rated as an
important need of parents in the NICU (Mundy, 2010).
Written and verbal communication has been found to be critical in
facilitating an infant’s discharge (Mills et al., 2006).
Interventions focused on improvement of communication between parents and healthcare providers
have been shown to increase overall patient satisfaction (Weiss et al., 2010).
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5. Plan
Objective
To improve communication between parents and the healthcare team by decreasing anxiety,
increasing trust and the efficiency of discharges through a daily nurse driven phone call to parents who
can not participate during bedside rounds.
Plan for Change/Test/Intervention
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Who Parents and Healthcare Team
What A nurse driven phone call to provide updates on the plan of care, changes
and to set/review goals.
Where NICU
How A convenient time will be scheduled with the parents who can not
participate in daily bedside rounds to receive a phone update on their
infants plan of care for the day, changes and goals to be met. Update on DC
Plan.

6. Plan
Arrange a time that will be convenient for the parents to receive updates.
Updates will consist of the following:
Weight (In pounds and oz.)
Length (In inches)
Significant Events (Apnea, Bradycardia, Desaturation)
Plan for the day:
(ie. increase feedings, start new medication, scheduled diagnostic test, eye exam)
Goals: (ie. take 3 feedings by mouth every shift, tolerate vent weaning)
Ask if they understand the plan and goals.
Ask if they have any questions or concerns that they would like addressed with the team.
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7. Plan
Measures:
HCAPHS and Discharge Phone Calls
Baseline/Pre-Project Implementation Data:
HCAPHS and DC calls will be reviewed to obtain the baseline data that will be used as the project’s
starting point.
Plan for data collection:
RN will review HCAPHS and Discharge Phone Call data to measure patient satisfaction during
December 2015- March 2016 in the NICU. Data will be compared and analyzed to determine if there
is at least a 10% improvement in patient satisfaction scores and feedback.
.
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8. Nursing Theme
 Process Improvement
Professional Practice Model Element(s)
 Quality-Safety Practice & Outcomes
Magnet Model Element
 Exemplary Professional Nursing Practice
TCAB Design Target(s)
 Patient Centeredness and Lean
.
Themes and Elements

9. Project Team
Team Lead: Geraldine Base
Selma Braziel (Nurse Manager)
Bevin Merideth (ANM)
Linda Lam ( Discharge Coordinator)
NICU RN staff
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10. What’s Keeping Me Up at Night
How to engage staff and get buy in without it looking like more work for them.
Establishing a time frame to call parents.
How to track that calls are being made.
How to keep momentum of the TCAB going.
How to keep information relayed succinct.
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11. References
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Mills, M. M., Sims, D., & Jacob, J. (2006). Implementation and case study
results of potentially better practices to improve the discharge
process in the neonatal intensive care unit. Pediatrics,
118, S124–S133.
Mundy, C. (2010). Assessment of family needs in neonatal intensive
care units. American Journal of Critical Care, 19(2),
156–163
Weiss, S., Goldlust, E., & Vaucher, Y. E. (2010). Improving parent satisfaction:
An intervention to increase neonatal parent-provider
communication. Journal of Perinatology, 30, 425–430.