The Challenge: Engaging Families during the Birth Hospitalization

Implementation of the Eat Sleep Console (ESC) tool and decreased use of pharmacologic therapy has contributed to great progress in reduction of the average length of stay for substance exposed infants within the CHoSEN Collaborative. While this care model has led to exciting outcomes, it requires significant support and time investment from both hospital providers and families, and we don’t yet fully understand how parents and caregivers are impacted by this new approach.

The Solution: Learning Directly from Families

To fill this gap, CHoSEN QIC has begun to engage birthing individuals in semi-structured qualitative interviews to better understand their birth hospitalization experience. By engaging directly with those involved, we aim to better understand the barriers and facilitators to implementing ESC and non-pharmacologic care during this time. These interviews focus on the following key areas:

  • The prenatal experience, including receipt of prenatal counseling
  • The birth hospitalization itself, including interactions with the healthcare team and benefits and challenges of using ESC
  • The transition from hospital to home, including follow-up care and anticipated challenges. 

Engaging in this process will allow us as a Collaborative to learn directly from those receiving this care with the goal of tailoring our interventions and approach to hospital care to best serve families.

While this work is ongoing, so far, three key areas have emerged as important for families during this time:

  • Setting clear and upfront expectations for how families can be successful during the birth hospitalization with their infant
  • Engaging in shared-decision making when pharmacologic treatment or transfer to the NICU may be needed
  • Preparing families for what to expect upon discharge and referring them to relevant community resources. 

One participant emphasized the importance of education throughout this process by saying, “One thing has been consistent through both of my experiences, I was very surprised at how every staff member, specifically the RNs knew a significant amount about withdrawal, the adverse effects of medication vs. no medication. They were very non-biased and very informative, and they all were consistent on what they knew, you can tell the information was accurate.” ​

Looking to Understand the Experiences of Families at Your Hospital?

If your hospital is interested in having families who receive care at your site share their experiences, CHoSEN QIC is currently conducting interviews with birthing individuals affected by substance use. This allows us to learn directly from individuals and families who have experienced caring for an infant prenatally exposed to substances and how we can best care for them during their birth hospitalization. To learn more about this opportunity, contact Dr. Stephanie Bourque

Dr. Bourque is a member of the CHoSEN QIC Steering Committee and is on faculty at the University of Colorado School of Medicine. Her clinical work as a neonatologist is primarily at Children’s Hospital Colorado and University Hospital. Within the CHoSEN Collaborative, Dr. Bourque’s focus is on optimizing family engagement, specifically during the birth hospitalization.

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