545 - Optimizing residents’ involvement in educational opportunities in the Neonatal Intensive Care Unit (ORION): A quality improvement initiative

Sunday, April 30, 2023

3:30 PM – 6:00 PM ET

Poster Number: 545
Publication Number: 545.324

Sara Neches, University of Washington School of Medicine, Seattle, WA, United States; Allison N. Lyle, University of Washington School of Medicine, Renton, WA, United States; Michelle J. Bartlett, University of Washington School of Medicine, SEATTLE, WA, United States; Samara R. Jinks-Chang, Johns Hopkins Children's Center, Baltimore, MD, United States; Maria Aleman, University of Washington, Department of Pediatrics, Seattle, WA, United States; Devin McKissic, University of Washington, Seattle, WA, United States; Catherine L. Baker, University of Washington, Seattle, WA, United States; Tiffany Stanley, University of Washington Medical Center, Seattle, WA, United States; Sara Berkelhamer, University of Washington School of Medicine, Seattle, WA, United States; Sara Durrani, University of Washington School of Medicine, Seattle, WA, United States; Thomas P.. Strandjord, University of Washington, Seattle, WA, United States; Kirtikumar Upadhyay, University of Washington School of Medicine, Seattle, WA, United States

Presenting Author(s)

Sara Neches, MD (she/her/hers)

Neonatology-Perinatology Fellow
University of Washington School of Medicine
University of Washington
Seattle, Washington, United States

Background:

Optimizing Residents’ Involvement in Educational Opportunities in the NICU (ORION) is a single center, multidisciplinary quality improvement initiative with a global aim of enhancing the educational experience and interdisciplinary work environment for pediatric trainees in the Level IV neonatal intensive care unit at the University of Washington Medical Center (UWMC).

Objective:

To improve resident satisfaction scores relating to educational experiences during NICU rotations by 30% by July 31, 2023.

Design/Methods:

We utilized a cross-sectional survey-based approach to obtain baseline data from pediatric trainees and bedside nurses regarding trainee learning experience, communication, and unit culture within the UWMC NICU. A 12-item REDCap survey was distributed to all residents (n=126), and a 15-item REDCap survey was distributed to all bedside nurses (n=100). Trainee satisfaction was evaluated using a Likert scale, and support for trainees was dichotomized over day and night shift as well as across multidisciplinary providers. Baseline data from trainee and nursing surveys and discussions with key stakeholders revealed lack of standardized orientation to the NICU, unequal division of patients, limited procedural experience and discrepancies between support and communication for residents between day and night shift as barriers to a supportive work environment. An inter-professional quality improvement team comprised of residents, fellows, neonatal APPs, Attending Neonatologists, NICU medical directors, nursing leaders, and bedside nurses was formed to develop and implement processes to improve the trainee experience. We identified four key areas for change: 1) Clinical Care Structure 2) Communication 3) Education 4) Unit Culture (Table 1).

Results:

Pre-intervention, n=31(65%) residents surveyed felt neutral, dissatisfied, or extremely dissatisfied with the NICU rotation. During the intervention phase, twenty-four (100%) residents completed virtual TeamSTEPPS communication training within 2-weeks of starting the NICU rotation. Fifteen (94%) first-year residents attended an in-person NICU orientation. Ten (42%) residents answered a post-rotation survey, and 100% of them felt satisfied or extremely satisfied with their NICU rotation (Fig 1). Data collection is ongoing.

Conclusion(s):

Taking an interdisciplinary approach to designing and implementing a structured resident orientation increased resident satisfaction during their NICU rotations. Future efforts should focus on improving opportunities for simulation-based training and optimizing team communication with a goal of improving patient safety.