Current State Evaluation: NICU

More than 10-15% of babies born in the United States require Neonatal Intensive Care (NICU) after birth. To care for those 500,000 infants, there are now over 900 NICUs operating throughout the country. Neonatal Intensive Care isn’t a one-size-fits-all solution, with a Level I to Level IV rating designation, there is a range of care options that exist for babies who are simply born before 35 weeks gestation, to those with severe medical problems and micro-preemies (born before 26 weeks). 

In the summer of 2019 a team of shadowers, process improvement specialists and data analysts, in cooperation with NICU nurses, physicians, and families, performed a current state analysis to understand the flow of the unit and map the daily experiences of staff and family members. With the vulnerable patient population unable to communicate and participate in their own care, directly experiencing the day to day life in the NICU from the point of view of those involved in and around the point of care was essential. Project goals included establishing a detailed process blueprint, documentation of staff workflow, and the current communication structure between caregivers, staff, and families. Real-time qualitative data was gained through 1:1 staff and family shadowing to identify processes that are scalable and those that could be improved.

The resulting current state analysis is the catalyst for targeting opportunities for improvement, especially related to flow and family experience. Based on this data, the recommendation was to create a communication protocol that will specifically focus on communication with family members before and during the NICU triage process. A particular focus will be paid to communication with parents experiencing an unexpected admission to the NICU. 

Stay tuned for updates on this project as it evolves and learn more about how to use a current state analysis as the first step in your process or experience improvement project by visiting

September is Neonatal Intensive Care Awareness Month. Designed to honor and commemorate those families who stay in the NICU and the amazing, dedicated professionals who care for their children, click here to learn more about NICA month.