Baby steps forward on the pathway towards improvement of neonatal care

Abstract

The thesis “baby steps forward on the path towards improvement of neonatal care” delves into the concept of "value" in neonatal intensive care. It discusses the definition of “value”, its measurement, and whether stakeholders share a common understanding. The thesis explores a value-based approach, aiming for optimal patient outcomes and efficient resource utilization. It emphasizes that the value of neonatal care extends beyond immediate results to encompass long-term quality of life and societal impact.

Measuring outcomes is crucial for improving value. It provides insights, guides patient- and parent/family-centered care, and has the potential to transform healthcare systems. The first section of the thesis includes studies on neonatal outcomes, such as acute kidney injury and hospitalization duration. The second part explores strategies to improve neonatal outcomes, including therapeutic hypothermia following lack of oxygen around birth in term infants or interventions to prevent brain hemorrhage in preterm infants. The third section considers safety and perception of quality of care from the perspectives of healthcare professionals and parents.

The thesis concludes by addressing challenges and recommending future research directions, such as balancing stakeholder perspectives and transitioning to value-based payment models. In summary, this thesis advocates a collaborative, patient- and family-centered approach to neonatal intensive care, with a focus on outcome measurement, care improvement, and adding value to interactions between parents and caregivers. It encourages individual care professionals, teams and organizations to reflect on how they can contribute to enhancing “value” in patient care.