Optimizing clinical care and training in the neonatal intensive care unit: the relationship between front line providers and physician trainees

Changes in neonatal intensive care unit (NICU) coverage models, restrictions in trainee work hours, and alterations to the training requirements of pediatric house staff have led to a rapid increase in utilization of front-line providers (FLPs) in the NICU. FLP describes a provider who cares for neo...

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Bibliographic Details
Published in:Journal of perinatology 2023-12, Vol.43 (12), p.1513-1519
Main Authors: Dyess, Nicolle Fernández, Keels, Erin, Myers, Patrick, French, Heather, Reber, Kristina, LaTuga, Mariam Susan, Johnston, Lindsay C., Scala, Melissa
Format: Article
Language:English
Subjects:
692/1537
692/700/1720
Child
Clinical Competence
Humans
Infant, Newborn
Intensive care
Intensive Care Units, Neonatal
Medical personnel
Medicine
Medicine & Public Health
Neonatal care
Neonates
Newborn babies
Patient Care
Patient Care Team
Pediatric Surgery
Pediatrics
Perspective
Physicians
Training
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Summary:Changes in neonatal intensive care unit (NICU) coverage models, restrictions in trainee work hours, and alterations to the training requirements of pediatric house staff have led to a rapid increase in utilization of front-line providers (FLPs) in the NICU. FLP describes a provider who cares for neonates and infants in the delivery room, nursery, and NICU, and includes nurse practitioners, physician assistants, and/or hospitalists. The increasing presence and responsibility of FLPs in the NICU have fundamentally changed the way patient care is provided as well as the learning environment for trainees. With these changes has come confusion over role clarity with resulting periodic conflict. While staffing changes have addressed a critical clinical gap, they have also highlighted areas for improvement amongst the teams of NICU providers. This paper describes the current landscape and summarizes improvement opportunities with a dynamic neonatal interprofessional provider team.
ISSN:0743-8346
1476-5543
DOI:10.1038/s41372-023-01749-7