Abstract
Background
Parental presence at bedside is a critical component of family-centered care for infants admitted to Neonatal Intensive Care Units (NICUs) and their caregivers, allowing for engagement with baby as well as education from the care team.
Local problem
Many families face barriers to physical presence, including transportation, childcare responsibilities, work, and illness, among others.
Interventions
Telehealth can be an avenue for parents to be engaged while not directly at bedside. This project details efforts to launch virtual visits in a Level III NICU, including challenges and lessons learned, across 4 PDSA cycles.
Methods
We measured the percentage of families on the NICU who attended 4 or more cares sessions per week. We obtained survey responses and open-ended feedback about the implementation from staff and patients.
Results
Family engagement rates were higher during active PDSA cycles at trending significance level. Most providers and parents rated the intervention as highly feasible and satisfying. Attendance in cares sessions improved across the QI project, especially for families with public insurance.
Conclusions
We found that telehealth visits were able to lessen the disparities in cares participation rates between families with private insurance and families with public insurance.
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Data availability
Data may be shared upon reasonable request to the corresponding author.
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Acknowledgements
We would like to thank the UCH NICU nurses and staff for participation in this quality improvement initiative. We would also like to thank UCH IT teams for creating solutions to integrate virtual care visits into patient portals.
Funding
This quality improvement initiative was funded by the University of Colorado Hospital Clinical Effectiveness & Patient Safety (CEPS) Grant Program and the University Hills Rotary Club. Jacob Holzman, PhD was supported by the National Institute of Mental Health (NIMH) 1K23MH134189. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
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All author contributions are described using the CRediT (Contributor Roles Taxonomy) system. JK: conceptualization, methodology, investigation, writing—original draft, writing—review and editing. DC: conceptualization, investigation, data curation, and writing—review and editing. JH: formal analysis, data curation, visualization, writing—original draft, and writing—review and editing. AS: visualization, data curation, project administration, and validation. KH: data curation, validation, and investigation. SS: writing—original draft. LB: conceptualization and supervision. JB: funding acquisition and conceptualization. JD: data curation, visualization, and formal analysis. AD: conceptualization, funding acquisition, supervision, and writing—review and editing.
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JB has been involved with content creation as Topic Co-Lead for the AI and Technology Forum on Healio Inc. and serves as the Site Co-Investigator for Aerofact Phase IIb clinical trial for Aerofact Inc. No other authors have conflicts of interest related to information presented in this manuscript to disclose.
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Kelleher, J., Cooke, D., Holzman, J.B.W. et al. A quality improvement initiative to increase family engagement and reduce disparities in visitation via telehealth in a level III neonatal intensive care unit. J Perinatol (2026). https://doi.org/10.1038/s41372-025-02527-3
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DOI: https://doi.org/10.1038/s41372-025-02527-3
