Wagenaar Josephine Hl, Broos Julia, van Beek Ron Ht, Pas Henrike, Suurveld Martijn, Jacobs Anne, Bodell Fredrik, Obermann-Borst Sylvia A, Cassel Florian, Kleinsmann Maaike S, Hinrichs-Krapels Saba, Reiss Irwin Km, Taal H Rob
Department of Neonatal and Pediatric Intensive Care, division of neonatology, Erasmus Medical Center Sophia Children's Hospital Rotterdam, Room Sk 2210, Dr Molewaterplein 40, Rotterdam, GD, 3015, The Netherlands.
Faculty of Technology Policy and Management, Institute for Health Systems Science, TU Delft, Delft, The Netherlands.
BMC Pediatr. 2025 Jul 29;25(1):574. doi: 10.1186/s12887-025-05923-y.
Real-time audiovisual communication between healthcare providers (HCP) at different hospitals (TeleNeonatology) can improve neonatal outcomes, address capacity challenges, and reduce emotional burden on parents. Despite its potential, TeleNeonatology has yet to be widely implemented in routine clinical care, partly due to non-optimal integration into care pathways and working routines. To provide insights for further adoption, this study presents the evaluation of a pilot in the Netherlands.
A prospective hybrid type III effectiveness-implementation study was conducted in 2024. During the pilot, a TeleNeo program facilitated both acute and elective communication between Erasmus MC NICU-level IV and Amphia NICU-level II. The TeleNeo program was developed and continuously improved during the pilot using co-creation with HCP and parents to enable embedding in care pathways and working routines. A mixed-methods approach was used for evaluation. The primary outcome was a validated 21-item usability questionnaire with five-points Likert Scale questions for parents ( = 50) and HCP ( = 85). Implementation determinants were evaluated with semi-structured interviews and surveys. Effectiveness was measured via parent reported experiences, and clinical outcomes length-of-stay and transfer rate.
Twelve months of implementation led to 99 consultations for 50 patients and families, including 33 acute patients, possibly in need of an acute transfer. Evaluation showed high feasibility and adoption. Usability was high among parents ( = 26, median score 5 [interquartile rage: 4–5]) and HCP ( = 48, median score 5 [interquartile range 4–5]). Parents valued rapid expert availability, involvement in transfer decisions, and experienced shared care between the NICUs. HCP observed quick and approachable communication, quicker medical decisions, improved quality of care, and smoother transitions between NICUs. Nurses were able to be more pro-active. In 18% (6/33) of acute cases transfers were perceived to be prevented. HCP highlighted TeleNeo’s influence on the local teams’ autonomy, communication styles, and financial aspects as important barriers in interviews ( = 12) and questionnaires ( = 65).
Pilot implementation showed high feasibility of our TeleNeo program, enabling shared care at the optimal location for our patients. Our findings will guide a robust strategy for implementation in the Southwest of the Netherlands, enhancing neonatal care, parental satisfaction and nursing experience.
The online version contains supplementary material available at 10.1186/s12887-025-05923-y.
不同医院的医疗服务提供者（HCP）之间的实时视听通信（远程新生儿学）可以改善新生儿结局，应对能力挑战，并减轻父母的情感负担。尽管具有潜力，但远程新生儿学尚未在常规临床护理中广泛实施，部分原因是未能最佳地融入护理路径和工作流程。为了为进一步采用提供见解，本研究介绍了对荷兰一项试点项目的评估。
2024年进行了一项前瞻性混合型III期有效性-实施研究。在试点期间，一个远程新生儿项目促进了伊拉斯谟医学中心四级新生儿重症监护病房（NICU）和安菲亚二级NICU之间的急性和选择性沟通。在试点期间，通过与HCP和家长共同创造来开发并持续改进远程新生儿项目，以使其能够融入护理路径和工作流程。采用混合方法进行评估。主要结局是一份经过验证的21项可用性问卷，其中包含针对家长（n = 50）和HCP（n = 85）的五点李克特量表问题。通过半结构化访谈和调查评估实施决定因素。通过家长报告的经历以及临床结局住院时间和转诊率来衡量有效性。
实施12个月导致为50名患者及其家庭进行了99次会诊，包括33名可能需要急性转诊的急性病患者。评估显示出高可行性和采用率。家长（n = 26）和HCP（n = 48）的可用性评分都很高（中位数分数均为5[四分位间距：4 - 5]）。家长重视专家快速可得、参与转诊决策以及体验到两个NICU之间的共享护理。HCP观察到沟通迅速且易于接近、医疗决策更快、护理质量提高以及NICU之间的过渡更顺畅。护士能够更加积极主动。在18%（6/33）的急性病例中，转诊被认为得以避免。HCP在访谈（n = 12）和问卷调查（n = 65）中强调，远程新生儿项目对当地团队的自主权、沟通方式和财务方面的影响是重要障碍。
试点实施表明我们的远程新生儿项目具有很高的可行性，能够在对患者最佳的地点提供共享护理。我们的研究结果将指导在荷兰西南部实施的稳健策略，提高新生儿护理、家长满意度和护理体验。
在线版本包含可在10.1186/s12887 - 025 - 05923 - y获取的补充材料。
