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Organization-wide collaboration brings babies closer to home

The Neonatal Nurse-Primary Care Paramedic team is one of this year’s PHSA+ Award recipients. Created during the pandemic, this interdisciplinary team came together to optimize patient flow, allowing babies to receive care closer to home.
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​​​​​​​​When critically ill newborns across B.C. and the Yukon need specialized services, the BC Women’s Hospital + Health Centre’s (BCWHHC) Neonatal Intensive Care unit (NICU) is their destination. The team cares for about 1,200 at-risk infants every year. 

The BC Emergency Health Services' (BCEHS) Infant Transport Team (ITT) is a specialized paramedic team that had been transporting newborns, pediatric and high-risk maternal patients to specialized care units in British Columbia. That is, until the COVID-19 pandemic put a strain on resources. 

Innovative thinking led to a new interdisciplinary team model to transport stable babies back to an NICU closer to home, resulting in fewer delays for families and better planning between BCWHHC and health authority partners and less strain on the ITT, freeing them up for the most acutely ill patient transports.

Team members from the NICU, ITT, Patient Transfer Network (PTN) and Perinatal Services BC (PSBC) came together to develop the Neonatal Nurse-Primary Care Paramedic (RN-PCP) model, making a huge impact on patient flow by taking on low acuity patient transports. Recognized as one of this year’s PHSA+ Awards recipients, we spoke to a few team members to learn more about their important work. 

Refining the process to move babies closer to home

​So far, the RN-PCP team has transported roughly 111 patients a year, helping to open beds for new patients in the NICU.

“We want to make sure we are moving babies to their home health authorities in a timely manner so they’re not staying in a hospital in Vancouver when they should be back in Abbotsford,” says Dr. Michael Castaldo, neonatologist at BCWHHC and neonatal transport medical lead. 

Deanna Wiebe, patient flow coordinator, was able to participate on a couple of transfers and witness the smooth process, which has been refined over time. “For me, it’s really nice to be able to tell the parents when exactly they will be transferred,” says Deanna. ​

“It has been encouraging to see how well they respond to the wh​ole process when we’re able to give them a timeline," says Deanna.

As with any new team, the RN-PCP group experienced some growing pains but quickly responded when faced with challenges. One example was paramedics having trouble finding the NICU at the BCWHHC campus during the early stages. 

“We thought people would know how to get to the NICU but when larger teams visited, they would sometimes get lost,” explains Cecilia Chow, neonatal program manager at BCWHHC. 

The team quickly adapted and developed a map that is now part of the standard operating procedure.  

A diverse group with the same focus: Patient and family-centred care​

​The RN-PCP team is made up of nurses, program coordinators, managers and neonatologists, with the involvement of ITT paramedics and BCEHS leads, the PTN and PSBC. 

Approval for the creation of this group was quick and involved a variety of stakeholders, including the director for risk management at PHSA and the BC Children’s Hospital and BCWHHC senior leadership team and Emergency Operations Centre. Formal planning for the RN-PCP team began in April 2020 and the first transport occurred a few months later in mid-July. 

“The team worked very hard to be able to launch this initiative within such a short timeline,” says neonatal program manager Jenna Johnston. 

“Everyone came together so quickly and collaborated to create a significant model despite the pandemic, which everyone was very busy responding to as well," says Jenna. 

Collaboration between programs around the province was crucial in the planning and training process. Advice from PSBC, the ITT team and NICU family advisors all helped to educate nurses and team members about best practices. 

For Michael, it was encouraging to see how open and welcoming everyone was of the new transport model.  “In the early phases, we had engagement from all levels. The primary care paramedics who were assigned to this hybrid system were so constructive and open to providing us feedback."

"I am so impressed by everybody who has touched this project,” says Michael.

Cecilia describes the team as highly motivated, with patients and families at the forefront of everything. “I think the team is very passionate about reuniting families to their home communities medically ready, as soon as possible,” she says.  

Receiving the PHSA+ Award surprising and motivating​

When asked about their reaction to receiving the PHSA+ Award, the team describes feeling flattered and surprised. For them, improving patient care was the only intention behind their work and being recognized was an added bonus. 

“The RN-PCP model was a collaborative initiative to improve the flow of patients and bring families closer to home—really our everyday work. For it to be recognized was unexpected and greatly appreciated by all those involved,” says Jenna. 

As a team that already aims to improve their processes through regular patient and employee surveys, receiving the PHSA+ Award has been motivation to keep improving and reflect on how incredible it was to see people come together with a common goal. 

“It is very motivating to know that the things we can achieve strengthen our collaboration with stakeholders,” says Michael. “It’s encouraging to see that when we collaborate like this, we can be quite successful.”​

​Congratulations to everyone at the RN-PCP team and thank you for your collaboration, commitment and dedication to your patients.​

About the PHSA+ Awards program
The PHSA+ Awards are part of an internal recognition program that celebrates teams and individuals who bring our PHSA values to life in the workplace. They go above and beyond to serve patients and families across B.C. Read about the other PHSA+ award recipients for 2021.

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