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Am J Perinatol 2024; 41(S 01): e2436-e2443
DOI: 10.1055/a-2115-8530
Original Article

Quality Indices and Outcomes of a Neonatology Telerounding Program in a Level II Neonatal Intensive Care Unit: Single-Center Experience during the COVID-19 Pandemic

Christine Cooper
1   Department of Pediatrics, Neonatology Regional Program, Seattle Children's Hospital, Seattle, Washington
,
Rossella Mastroianni
2   Division of Neonatology, Department of Pediatrics, University of Washington, Seattle, Washington
,
Elena Bosque
1   Department of Pediatrics, Neonatology Regional Program, Seattle Children's Hospital, Seattle, Washington
,
Shilpi Chabra 
3   Division of Neonatology, Department of Pediatrics, University of Washington and Seattle Children's Hospital, Seattle, Washington
,
Julie Campbell
2   Division of Neonatology, Department of Pediatrics, University of Washington, Seattle, Washington
,
Jose A. Perez
3   Division of Neonatology, Department of Pediatrics, University of Washington and Seattle Children's Hospital, Seattle, Washington
,
Cailin F. White
2   Division of Neonatology, Department of Pediatrics, University of Washington, Seattle, Washington
,
Jasmine E. James 
2   Division of Neonatology, Department of Pediatrics, University of Washington, Seattle, Washington
,
Rachel A. Umoren
3   Division of Neonatology, Department of Pediatrics, University of Washington and Seattle Children's Hospital, Seattle, Washington
› Author Affiliations
Funding None.
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Abstract

Objective The objective of this program evaluation was to describe the outcomes of daily neonatologist telerounding with the onsite advanced practice provider (APP) in a Level II neonatal intensive care unit (NICU), before and during the coronavirus disease 2019 (COVID-19) pandemic.

Study Design Bedside telerounding occurred with an onsite APP using a telehealth cart and paired Bluetooth stethoscope. Data collected by longitudinal and cross-sectional surveys and chart review before (May 2019–February 2020) and during (March 2020–February 2021) the COVID-19 pandemic were analyzed using descriptive statistics and thematic analysis.

Results A total of 258 patients were admitted to the Level II NICU before (May 2019–February 2020) and during (March 2020–February 2021) the COVID-19 pandemic. Demographic characteristics and outcomes, including breastfeeding at discharge and length of stay were similar pre- and postonset of the COVID-19 pandemic. Postrounding surveys by 10 (response rate 83%) neonatologists indicated parents were present in 80 (77%) of rounds and video was at least somewhat helpful in 94% of cases. Cross-sectional survey responses of 23 neonatologists and APPs (response rate 62%) indicated satisfaction with the program. Common themes on qualitative analysis of open-ended survey responses were “need for goodness of fit” and “another set of eyes” and “opportunities for use.”

Conclusion Daily telerounding with neonatologists and APPs in a Level II NICU supported neonatal care. Quality metrics and clinical outcomes are described with no differences seen before and during the COVID-19 pandemic.

Key Points

  • Little is known about Level II NICU quality metrics and outcomes.

  • Daily bedside telerounding with neonatologists and APPs is described.

  • Telerounding supported neonatal care before and during the COVID-19 pandemic.

  • Neonatologists found visual exam helpful in the majority of cases.

  • No differences in NICU clinical outcomes were seen during the COVID-19 pandemic.

Keywords

neonatology - advanced practice providers - telemedicine - telerounding - outcomes


Publication History

Received: 03 March 2023

Accepted: 21 June 2023

Accepted Manuscript online:
22 June 2023

Article published online:
29 July 2023

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