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NICUs transitioning away from shift work to improve patient health, worker health and hospital costs

January 31, 2020

Working a few days in a row and then having a few days off in a row is often better for neonatologists because it puts them into a routine and gives them mental health relief from work, along with many other benefits. If the entire hospital staff is relaxed and healthy, there is more time and energy to focus towards patients, thus resulting in better outcomes for preemies in NICUs.

Better business model
From the hospital business perspective, there are a number of reasons to transition away from shift work. First is the opportunity to improve patient satisfaction ratings due to parents/family members of the patients feeling more at ease with a physician or nurse that they’re familiar with. It comes as no surprise that shifts greater than 13 hours have been linked to patient dissatisfaction with physician communication and level of care, which resulted in the patient not recommending the hospital.

Another aspect of implementing continuous care is the associated cost savings. The standardization of care by one doctor will improve outcomes by decreasing errors associated with multiple handoffs, which in turn shortens the length of patient stays and ultimately saves both hospitals and patients money. The Medscape study found that 30-day post discharge costs were $223 lower per patient when hospitalists work several consecutive days.

Make the scheduling change
In order for a hospital to introduce this new scheduling format, it’s important to evaluate the current scheduling system and get in weigh in from the medical staff. Present the idea to doctors and mid-level employees and explain the implications of implementing this new scheduling model--improved patient outcomes, healthier staff and a better business model. With their support and the proper management structure, transitioning neonatologists away from shift work will be attainable and the positive impact on all parties will be apparent almost immediately.

About the author: Dr. Kathrotia is dual-boarded in General Pediatrics and Neonatal-Perinatal Medicine, and serves as Managing Partner and Chief Operating Officer of Millennium Neonatology, a practice management firm for Neonatal Intensive Care and Newborn Services.

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