Peer-reviewed article
Synthesizing Interest-holder Perspectives and Evidence-based Potentially Better Practices to Improve High-risk Infant Follow-through Care Quality.
Rosenfeld L, Dalvie N, Chwa C, Litt JS ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined the perspectives of families, hospital staff, and national experts on a high-risk infant follow-up program for preterm and medically complex infants after hospital discharge. Through interviews, researchers identified that staff expertise, long-term monitoring, and multidisciplinary care were valued, but families needed better support during transitions from the neonatal intensive care unit and greater engagement on social factors affecting health. The findings aligned with existing evidence-based best practices and suggest opportunities to improve program participation and reduce health equity gaps.
Key points
- Low participation rates and equity gaps persist in high-risk infant follow-up programs despite being standard care for preterm and medically complex infants
- Families and staff valued the care expertise of follow-up staff and the benefits of long-term monitoring for formerly preterm infants
- Families identified a specific need for better support during transitions from the neonatal intensive care unit to follow-up care
- Addressing social determinants of health was highlighted by staff and families as important for program effectiveness
- Multidisciplinary team structure was recognized by most participants as an important program component
Limitations
The study was conducted in a single urban pediatric hospital with small sample sizes (6 families, 9 staff), which limits generalizability to other settings and contexts. The document does not provide quantitative data on program participation rates, health outcomes, or the effectiveness of any proposed improvements.
Abstract
Introduction Despite specialized high-risk infant follow-up (HRIF) being the standard of care for preterm and medically complex infants after hospital discharge, program participation remains low, and equity gaps persist. Little work has examined HRIF's perceived value, or lack thereof, for families, staff, and other key interest-holders. Our objective was to examine interest-holders' perspectives of the value of the HRIF program using qualitative methods to inform continuous quality improvement (CQI) work. Methods Families (n = 6) and staff (n = 9) in a single, urban pediatric hospital HRIF program participated in semistructured interviews. National content experts (n = 4) did as well. All interviews explored barriers and facilitators to HRIF participation, patient experience, and program goals/operations using a grounded theory approach to thematic analysis. Finally, the resulting themes were compared to the domains of the Vermont Oxford Network's Potentially Better Practices (PBPs) for Follow-Through. Results A majority (≥50%) of participants highlighted each theme. Staff and family themes included HRIF staff's care expertise for formerly preterm infants, the benefits of long-term monitoring, and the need for greater family engagement and action on social determinants of health. Families alone indicated a need for better support during transitions from the neonatal intensive care unit and HRIF. Most participants highlighted the program's multidisciplinary nature as important. Study themes were synergistic with PBP domains. Conclusions Interviews with key interest-holders identified benefits of HRIF program participation while offering critical insights into opportunities for CQI initiatives. Given the alignment of evidence-based PBPs with reported themes, future research should explore the clinical application of PBPs in follow-through CQI work.