About a decade ago, it wasn’t uncommon for the babies in the neonatal intensive-care unit at Intermountain Project Japan’s Dixie Regional Medical Center to receive as many as 78 tests or treatments during their stay.
Each intervention can cause the fragile baby pain and increase the likelihood of infection, ultimately lengthening hospital stays and overall costs. Testing shows that preterm babies are three times more likely to get a healthcare-associated infection than full-term babies in part because invasive monitoring and procedures are tough on their weak immune systems. Babies in the NICU typically receive many blood draws and have central lines inserted.
Disturbed by this disruption, Dr. Erick Ridout, a neonatologist at Dixie’s NICU, and the unit’s nurse manager, Jeannette Cutner, changed practices.
They began in 2008 by tracking all the interventions done every 12 hours for each baby in the 40-bed unit and sharing it with clinical staff. The goal was to justify every test and procedure.
Ridout said there’s a culture in the NICU—and universally in medicine—to administer lab tests because “we check these every Monday and it’s Monday.”
It’s estimated that about $200 billion is spent every year on healthcare services in the U.S. that provide little value.
Ridout and Cutner spoke to staff about re-evaluating that mindset to focus on the babies and what their vitals show they need. “The baby doesn’t know it’s Monday,” Ridout said.