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Description

INNOVATION

Background
Within a Level IV collaboration between different disciplines and departments is needed to provide care delivery that is effective and efficient. Emergent situations arise that require care to be provided quickly, including patients with necrotizing enterocolitis (NEC) and/or require bedside surgery. Upon review, multiple inconsistencies and inefficiencies were identified in these processes.

Implementation
Utilizing Lean and Quality Improvement methodology, CPGs were created for both necrotizing enterocolitis and bedside surgery. The steps taken in creation of these CPG include:
• Identification of key stakeholders of all departments, including neonatology, surgery, and anesthesia
• Evaluation of the Sepsis CPG to allow for consistency in huddle practices and recommendations
• Add care specific to NEC and/or perforation based on literature review
• Once NEC CPG were finalized, bedside surgery CPG was started
• First step was to identify current state through a swimlane process map, including all disciplines and departments in the creation
• Identify areas of waste, gaps, and recommendations for new process
• Re-create swimlane process map with recommendations, and create a standard work document for all disciplines
• Include standard work documents in the bedside surgery CPG
• After creation of CPG, dissemination to all disciplines and departments to review, edit, and agree upon recommendations

Evaluation
Both CPGs went live in August 2024. Including all key stakeholders in the beginning allowed for an efficient and effective way to evaluate all care practices and recommendations moving forward. This allowed for communication about expectations for roles and responsibilities, evaluate and decrease waste, and reset expectations for all involved. Next steps will be to monitor and track consistency and utilize PDSA methodology to make modifications as needed.

Publication Date

9-27-2024

Keywords

Innovation, NICU, CPG, Clinical Practice Guidelines

Disciplines

Pediatric Nursing

Collaboration is Key: Engaging a Multidisciplinary and Multi-Departmental Team to Create Clinical Practice Guidelines (CPG) within a Level IV NICU

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