Integrating Stakeholder Priorities for the Optimization of Care of the Preterm Infant in a Safety-Net NICU

Abstract

Objective This study aimed to engage clinical and community stakeholders to create a prioritization matrix of interventions to reduce neonatal brain injury and improve neurodevelopmental outcomes.

Study Design We collaborated with our community partner to establish a Lived Experience Advisory Group (LEAG). Faculty performed a literature review to identify neonatal neuroprotective interventions; additional priorities from the LEAG were also included. Project leaders scored and presented intervention bundles for impact. Stakeholder priorities for value/feasibility were obtained via questionnaire. Mean values were incorporated into a prioritization matrix.

Results Themes from discussions with LEAG members included the role of the neonatal intensive care unit (NICU) parent, the experience of trauma, shared decision-making, communication and trust with the health care team, and bias in medical care. Five interventions were placed in the highest priority quadrant of the prioritization matrix: thermoregulation, maternal antepartum steroids, delayed cord clamping, optimized oxygen delivery, and optimized glucose regulation.

Conclusion It is feasible to incorporate community and parent values into clinically oriented neuroprotective intervention bundles for preterm infants. This clinical–community collaboration is vital to ensure that our project objectives meet the needs and priorities of the population it is intended to serve.

Key Points

• Including input from parent advisory groups supports interventions that meet the needs of families.

• Collaboration between clinical and community stakeholders can improve neuroprotective and neurodevelopmental strategies.

• Incorporation of clinical interventions into a prioritization matrix improves resource utilization.

• Five perinatal interventions were ranked highly for impact and feasibility in the prioritization matrix.

Keywords

neonatal brain injury - neurodevelopment - intervention bundle - community stakeholders - Lived Experience Advisory Group - prioritization matrix

Authors' Contributions

E.S. made substantial contributions to the conceptualization, methodology, and investigation of the study, and co-drafted the initial manuscript. M.L. contributed to the investigation of the study and co-drafted the initial manuscript. N.M. and J.R. made substantial contributions to the conceptualization, methodology, and investigation of the study, and critically reviewed the manuscript. G.B., K.B., K.M., M.J., S.P., D.R., and A.S. participated in the investigation of the study and critically reviewed the manuscript. All authors have reviewed and approved the final version of the submitted manuscript.

^* These are co-first authors.

Publikationsverlauf

Eingereicht: 19. Juni 2024

Angenommen: 04. November 2024

Artikel online veröffentlicht:
04. Dezember 2024

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