Multiprofessional cross-site working between a level 1 and a level 3 neonatal unit: a retrospective cohort study

Theodore Dassios*, Lucksini Selvadurai, Ann Hickey, Elizabeth Sleight, Lisa Long, Leonie Penna, Vivette Wallen-Mitchell, Ravindra Bhat, Anne Greenough

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objective To assess the association of short-term neonatal outcomes with cross-site working of multiple healthcare professional teams between a level 3 and a level 1 neonatal unit. Design Retrospective cohort study. Setting A level 1 neonatal unit in London. Patients All infants admitted to the neonatal unit, between 2010 and 2021. Interventions The clinical service was rearranged in 2014 with the introduction of cross-site working between the level 1 unit and a level 3 unit of neonatal doctors, nurses and allied healthcare professionals. Main outcome measures Admission of infants with a temperature less than 36°C, length of stay and time to first consultation by a senior team member. Results A total of 4418 infants were admitted during the study period. The percentage of infants delivered at a gestation below 32 weeks was higher in the pre-cross-site period (8.9%) compared with the cross site period (3.6%, p<0.001). The percentage of infants with an Apgar score less than 8 at 10 min was higher in the pre-cross-site period (6.2%) compared with the cross-site period (3.4%, p=0.001). More infants were admitted with a temperature less than 36°C in the pre-cross site period (12.3%) compared with the cross site period (3.7%, p<0.001). The median (IQR) duration of time to first consultation by a senior team member was higher in the pre-cross-site period (1 (0.5-2.6) hours) compared with the cross-site period (0.5 (0.2-1.3) hours) (p<0.001). The median (IQR) length of stay was 4 (2-11) days in the pre-cross-site period and decreased to 2 (1-4) days in the cross-site period (p<0.001). Conclusions Cross-site working was associated with lower rates of admission hypothermia, shorter duration of stay and earlier first senior consultation.

Original languageEnglish
Article numbere001581
JournalBMJ Paediatrics Open
Volume6
Issue number1
DOIs
Publication statusPublished - 22 Sept 2022

Keywords

  • Neonatology

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