Resident Physician Eastern Virginia Medical School Norfolk, Virginia, United States
Background: Kangaroo Care (KC) - a technique in which newborn infants are placed directly on their parent’s chest with minimal clothing - is a core developmental practice of newborn care worldwide with evidence supporting its reduction in complications of preterm delivery, strengthening of child-parent dyad, and improved neurodevelopmental outcomes for the patient. KC is in use at our NICU, yet equitable practice data is lacking. This initiative aims to identify health equity gaps related to KC and employ Quality Improvement (QI) science for their reduction. Objective: Increase the average length of KC sessions of Black infants at our institutional NICU from 84 to 104 minutes (21%) by July 2024. Globally we aim to improve neurodevelopmental outcomes of neonates in the NICU by way of KC and decrease gaps in health equity regarding KC and neurodevelopmental outcomes. Design/Methods: IHI Model for Improvement was used to create an aim statement, project charter, team outline, and stakeholder analysis. To assess KC practices, we defined variables, collected EMR baseline data, created a process map, designed a key driver diagram, and planned PDSA cycles.
Preliminary data indicates an average of nine KC sessions in the first 30 days. There's no significant raw session difference by race/ethnicity. However, there's a disparity in KC duration. Black families average 82 minutes per session, while White families average 104 minutes. No data is available for Hispanic families.
Initial findings of our data reveal a notable health disparity, particularly in the duration of KC sessions. We anticipate additional data collection to enable a more comprehensive analysis. Upcoming PDSA cycles will focus on introducing a standardized logbook system to enhance data accuracy and, concurrently, to foster meaningful engagement and connection for participating families with their neonate's progress. Subsequent PDSA iterations will consist of a comprehensive informational package that explains Kangaroo Care, highlights its benefits, and guides family members in active participation.
