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:

Gay men and lesbian women less likely to be employed in a leadership position
Gay men and lesbian women face discrimination when seeking leadership positions due to the sound of their voice, a new study in the Archives of Sexual Behaviour has found.
Dan Sinars represents Sandia in first energy leadership class
Dan Sinars, a senior manager in Sandia National Laboratories' pulsed power center, which built and operates the Z facility, is the sole representative from a nuclear weapons lab in a Department of Energy leadership program that recently visited Sandia.
Meeting will highlight global leadership in education, aging
The Association for Gerontology in Higher Education (AGHE) -- the educational branch of The Gerontological Society of America -- will hold its 43rd Annual Meeting and Educational Leadership Conference, taking place from March 9 to 12 at the Miami Marriott Dadeland in Miami, Florida.
Improving school leadership is topic of guide for education officials
Research suggests that school leadership can be a powerful driver of improved educational outcomes, with research suggesting that principals are second only to teachers as the most important school-level determinant of student achievement.
UT AgResearch Dean recognized for leadership excellence
Bill Brown, dean of University of Tennessee AgResearch, received an Excellence in Leadership Award during the annual meeting of the Association of Public Land-grant Universities (APLU).
Leadership expert says political skills important to leader satisfaction
Political skill is a fundamental quality of a transformational leader and being good at it can increase job satisfaction and engagement, according to research published by Andrew Wefald, associate professor in the Staley School of Leadership Studies, and Kansas State University alumni Kyle van Ittersum and Jennifer Mencl.
How telecommuting can cause leadership issues for your company
Wherever your organization falls on the spectrum of telecommuting and virtual teams, new research from Georgia Southern University and BYU reveals something about leadership and telecommuting that everyone should take into consideration.
Workplace well-being linked to senior leadership support, new survey finds
Despite the prevalence of workplace wellness efforts, only one-third of American workers say they regularly participate in the health promotion programs provided by their employer, according to a new survey by the American Psychological Association.
Leadership: Key to quality care and retention among nurses
Nurses faced with abusive managers are more likely to quit.
Leadership study hints that age beats height
New research out of the University of Melbourne suggests that when it comes to good leadership at the Olympic level, age trumps physical stature.

Related Leadership Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Climate Crisis
There's no greater threat to humanity than climate change. What can we do to stop the worst consequences? This hour, TED speakers explore how we can save our planet and whether we can do it in time. Guests include climate activist Greta Thunberg, chemical engineer Jennifer Wilcox, research scientist Sean Davis, food innovator Bruce Friedrich, and psychologist Per Espen Stoknes.
Now Playing: Science for the People

#527 Honey I CRISPR'd the Kids
This week we're coming to you from Awesome Con in Washington, D.C. There, host Bethany Brookshire led a panel of three amazing guests to talk about the promise and perils of CRISPR, and what happens now that CRISPR babies have (maybe?) been born. Featuring science writer Tina Saey, molecular biologist Anne Simon, and bioethicist Alan Regenberg. A Nobel Prize winner argues banning CRISPR babies won’t work Geneticists push for a 5-year global ban on gene-edited babies A CRISPR spin-off causes unintended typos in DNA News of the first gene-edited babies ignited a firestorm The researcher who created CRISPR twins defends...