Nav: Home

The 'secret sauce' for high-performing NICUs

July 23, 2018

Leaders of neonatal intensive care units (NICUs) across the nation share the same play books as they strive to provide safe, high-quality medical and surgical care for vulnerable newborns. A growing number of quality collaborations share best practices and evidence-based guidelines across the nation in the hopes of replicating quality and safety success stories while minimizing harms.

Still, NICUs that use similar interventions in similar fashions often do not achieve identical results.

"This unexplained variability in outcomes between NICUs begs the question: What is the secret sauce? Why do some NICUs consistently outshine others in spite of the application of the same 'potentially best practices,' " the leaders of Children's award-winning NICU ask in an editorial published online July 12, 2018, by Archives of Disease in Childhood (ADC) - Fetal & Neonatal edition.

Quoting the literature, Lamia Soghier, M.D., Children's NICU medical director, and Billie Lou Short, M.D., chief of Children's Division of Neonatology, write that hospitals with strong performance-improvement programs share eight critical factors in common:
  • Strong performance-improvement leadership at the administrative and executive levels
  • Boards of Trustees who are actively involved and provide continuity in vision regardless of changes in senior hospital leadership
  • An effective oversight structure that avoids duplicating efforts
  • Expert performance-improvement staff who are trained in quality and safety and able to carry out projects successfully
  • Physicians who are involved and held accountable
  • Staff who are actively involved
  • Effective use of data in decision-making
  • Effective communication strategies for all stakeholders


The " 'secret sauce' may lie in establishing systems that promote the culture of quality and safety rather than waiting for a reduction in morbidity," write Drs. Soghier and Short.

For the second year running, Children's neonatology division ranked No. 1 among NICUs ranked by U.S. News & World Report. Despite challenges inherent in being a "busy level IV NICU in a free-standing children's hospital with a rapidly growing capacity, higher levels of complex patients, [the] presence of trainees on rounds and routine 3:1 and 2:1 staffing models," Children's NICU has continued to have the lowest rates of such objective quality measures as central line-associated bloodstream infections and unintended extubations, they write.

"We attribute our success to direct involvement of all levels of leadership in our unit in [performance improvement] PI initiatives, a dedicated local PI team, quality trained medical unit director, engagement of front-line staff in PI, the presence of local subject-matter experts, multidisciplinary diverse team both within the NICU and with other departments that bring an array of experiences and opinions and a supportive data infrastructure through local information technology, and use of the Children's Hospital Neonatal Database that allows benchmarking to other non-delivery NICUs, Drs. Soghier and Short write. "Our team finds motivation in solving local issues routine in our work, and leadership prioritises these issues and promotes engagement of front-line staff."

The commentary was a companion to "Using a Composite Morbidity Score and Cultural Survey to Explore Characteristics of High Proficiency Neonatal Intensive Care Units," also published by ADC Fetal & Neonatal.
-end-


Children's National Health System

Related Leadership Articles:

Women in leadership positions face more sexual harassment
Power in the workplace does not stop women's exposure to sexual harassment.
Collective leadership groups maintain cohesion and act decisively
Members of collective leadership groups can maintain cohesion and act decisively when faced with a crisis, in spite of lacking the formal authority to do so, according to new research from Cass Business School.
Leadership's in the blood for tiny fish
Leadership during cooperation runs in the family for tiny fish called Trinidadian guppies, new research shows.
Rice study assesses college leadership training programs
A new study from psychologists at Rice University found they teach students about leadership, but additional measures are needed to evaluate how they impact students' real-life leadership skills.
These four values lessen the power of transformational leadership
Transformational leadership is considered one of the most effective ways to motivate and inspire employees.
Preventing toxic work environments through ethical leadership
Recently published research from SDSU management professor, Dr. Gabi Eissa and University of Wisconsin -- Eau Claire management professor, Dr.
Women, your inner circle may be key to gaining leadership roles
According to a new Notre Dame study, women who communicate regularly with a female-dominated inner circle are more likely to attain high-ranking leadership positions.
Feminine leadership traits: Nice but expendable frills?
The first study to examine tradeoffs in masculine versus feminine leadership traits reveals that stereotypically feminine traits -- like being tolerant and cooperative -- are viewed as desirable but ultimately superfluous add-ons.
Leadership and adaptive reserve are not associated with blood pressure control
Primary care leadership and practice resilience can strengthen organizational culture.
Values and gender shape young adults' entrepreneurial and leadership
Young adults who are driven by extrinsic rewards and money and less by a sense of security are more likely to want to become entrepreneurs and leaders, according to a recent study.
More Leadership News and Leadership Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Climate Mindset
In the past few months, human beings have come together to fight a global threat. This hour, TED speakers explore how our response can be the catalyst to fight another global crisis: climate change. Guests include political strategist Tom Rivett-Carnac, diplomat Christiana Figueres, climate justice activist Xiye Bastida, and writer, illustrator, and artist Oliver Jeffers.
Now Playing: Science for the People

#562 Superbug to Bedside
By now we're all good and scared about antibiotic resistance, one of the many things coming to get us all. But there's good news, sort of. News antibiotics are coming out! How do they get tested? What does that kind of a trial look like and how does it happen? Host Bethany Brookeshire talks with Matt McCarthy, author of "Superbugs: The Race to Stop an Epidemic", about the ins and outs of testing a new antibiotic in the hospital.
Now Playing: Radiolab

Speedy Beet
There are few musical moments more well-worn than the first four notes of Beethoven's Fifth Symphony. But in this short, we find out that Beethoven might have made a last-ditch effort to keep his music from ever feeling familiar, to keep pushing his listeners to a kind of psychological limit. Big thanks to our Brooklyn Philharmonic musicians: Deborah Buck and Suzy Perelman on violin, Arash Amini on cello, and Ah Ling Neu on viola. And check out The First Four Notes, Matthew Guerrieri's book on Beethoven's Fifth. Support Radiolab today at Radiolab.org/donate.