NICUtrition Tier 3: BeST Practices

**Promote Data Enabled Decision-Making** - NICUtrition allows you and the care team to access a comprehensive feeding history of each patient, with overlays of events and outcomes together, with protocol compliance data and EMR integration, enabling more informed and effective care decisions for your most vulnerable NICU patients. **Simplify the Workflow** - NICUtrition generates real-time ongoing analytics of feeding data with automated reporting via real-time alerts to simplify your workflow, allowing you to spend less time on documentation and more time with your patients and their families. The data immediately populate the EHR giving the next shift instant access to documentation regarding previous feedings. **Access to Real-Time Data** - NICUtrition makes it easy to view and adjust feeding schedules for better nutrition management; monitor activity to ensure staff compliance with all orders, conduct compliance benchmarking and set goals to improve patient outcomes. **Improve Productivity** - NICUtrition's more structured and streamlined approach to feeding protocols paves the way for increased staff productivity, performance and overall satisfaction, allowing your team to deliver the best care possible in your NICU. **Improve Financial Growth/Profitability** - NICUtrition can transform nutrition care management in your NICU allowing you to standardize and adhere to feeding protocols for more consistent quality care delivery; simplify workflows for improved productivity and operational efficiency; and make data-enabled clinical decisions to drive better outcomes, reduce length of stay and reduce costs to promote profitability. **Optimize Patient Care and Comfort** - The NICUtrition clinical dashboard puts quality care right at your fingertips, featuring an intuitive display of the feeding protocol with clear instructions so you can address the specialized nutritional needs of your preterm patient with confidence every time. **Consistently Deliver Quality Care** - NICUtrition offers easy online access to feeding data with the ability to monitor and measure staff protocol compliance in order to ensure consistent delivery of quality care. The system also helps to identify possible gaps and opportunities for staff education and training to improve performance. **Generate Evidence-Based Care Data** - NICUtrition delivers real-time ongoing monitoring and analysis of the NICU's feeding protocols using actual patient data, which helps ensure greater compliance, improve quality of care and drive better outcomes. **Enforce Quality Control & Improvement** - NICUtrition allows health systems to effectively measure adherence to feeding protocols and determine the degree to which preterm infants may be impacted by the NICU team's ability or inability to follow its own protocol, so steps may be taken as needed to improve performance and quality within the unit. **Uphold Clinical Excellence** - NICUtrition promotes team collaboration, data-enabled clinical decision-making and protocol adherence for improved patient nutrition, empowering your neonatal team to deliver exceptional care for your most vulnerable NICU patients. **Improve Patient Outcomes** - NICUtrition helps clinicians and their teams understand trends in milestones and outcomes to promote positive patient growth and development with a shortened length of stay (LOS) in the NICU. It can incentivize the team to establish clear guidelines for best practices in neonatal nutrition management which leads to consistent delivery of quality care. **Reduce Cost of Care** - NICUtrition promotes standardization with valuable real-time feeding data and analytics to help the NICU team make better informed clinical decisions with greater efficiency to support the positive growth and development of preterm infants, leading to better outcomes, reduced length of stay and reduced costs. **Automate Quality Reporting** - NICUtrition provides an efficient and cost-effective way for health systems to generate detailed Quality Collaborative or Quality Initiative reports and support research efforts by customizing, streamlining and standardizing data extraction. **Reinforce Treatment Decisions** - NICUtrition lets you view delivered feeds and outcome analyses, allowing you to make informed decisions and adjust treatment regimes quickly as needed based on the changing needs of the preterm infant. **Enhance Technical Integration** - The NICUtrition system meets FHIR HL7 standards and can be integrated with EHR systems, like EPIC and Cerner, through flowsheets and APIs.

This platform is exclusively used in the neonatal intensive care unit (NICU) for preterm infants born under 34 weeks.

NICUtrition BeST Practices automates feeding plans based on protocol and allows users to approve and modify feed level data at any point in the care delivery process. The real-time alerts and structured care logs keep the entire care team up-to-date on the infant’s nutritional status at all times. Full implementation of BeST Practices will save documentation time and increase the volume of structured, referenceable data entered. Benefits for this product include: - Facilitates consistent delivery of care - Simplifies workflow and decreases documentation time - Improved documentation – standardize information, eliminate gaps, capture structured data for improved reporting The types of users who could benefit from this product include: **Registered Neonatal Nurse** - A member of the NICU team, responsible for the daily care and feeding of premature and intensively ill newborns. Duties include but are not limited to: administering medications; monitoring vital signs; providing vital nutrients to these extremely vulnerable patients; assisting in treatment plans and examinations with clinical specialists and NICU staff. The nurse is responsible for tracking, maintaining and updating patient care records and to keep the parents informed of their baby's condition/progress and comforted as needed. **NICU Nurse Manager** - Oversees daily unit operation and supervises nursing staff to ensure delivery of quality care; tracks and analyzes productivity and quality outcomes; implements process improvement strategies as directed and collaborates with director, staff and interdisciplinary team to standardize or update policies and procedures while ensuring internal and regulatory compliance. Accountable for staffing and scheduling while promoting accountability, empowerment and performance. **Neonatal Nurse Practitioner** - Works in collaboration with the neonatologist (or neonatal fellow) and other members of the NICU and/or interdisciplinary team to assess, diagnose, and treat premature or critically ill newborn patients. Duties include but are not limited to: participating in rounds; writing orders; initiating medical procedures and tests; monitoring specialized NICU equipment; prescribing medication and treatment as required; and advising parents regarding the patient's condition as well as their proper treatment and care. **Neonatologist (Level III/IV NICU)** - Pediatric doctor specifically trained to handle the most complex and high-risk medical issues associated with the birth and development of premature and intensively ill newborn patients. Responsible for overall care management of at-risk newborns in the NICU, including the assessment, diagnosis, and treatment as well as assistance with high-risk births and surgeries. Duties include but are not limited to: conducting rounds; writing orders; performing medical procedures and tests; prescribing medication and treatment; informing and advising parents regarding their infant's condition and treatment; collaborating/consulting with other medical specialists as required, ensuring the patient receives the proper nutrition for optimal growth and development and active involvement in research and clinical trial activities. **Neonatal/Pediatric Dietician** - Registered dietician with specialized training and experience in neonatal nutrition works with members of the NICU team and other clinical specialists as needed, to assess the newborn's medical condition and prepare an individualized nutritional care plan -- considering the feeding method, medications and nutritional requirements -- to support proper healing, growth and development. Duties include but are not limited to: rounding; consultation; plan development, implementation and evaluation; monitoring and tracking of the infant's intake, calorie consumption, nutrient absorption, changes in patient weight and size, as well as addressing and accounting for any adverse events that arise. **NICU Medical Director (Level III/IV)** - As a member of the management team, the director is responsible for planning, organizing and influencing the delivery of quality patient care in the NICU. The director is responsible for department staffing as well as creating, leading and participating in quality and evidence-based neonatal initiatives. Additionally, he/she is involved in policy planning, development, and implementation, while working to ensure that the policies effectively align with the overall goals of the health system. The director works to ensure staff adherence to regulatory guidelines and compliance to quality and safety standards and collaborates with other directors, staff and departments to maintain optimal services and manage costs. **Maternal/Infant Care Services Line Director** - The service line director manages the departmental sub-function within the health system. Responsible for establishing effective strategies for programs, product/service line development, physician integration and resource utilization in order to achieve product/service line growth, efficiency, improved patient experience and overall quality care. Develops budgets, policies and procedures to support the functional infrastructure. **Chief Quality Officer** - Oversees all quality, risk management and patient safety related activities throughout the health system. Responsible for maintaining the facilities system-wide Quality program, including: data collection, aggregation and analysis; maintaining policies and procedures; and reporting to administrators, medical staff and the board of directors. Directs all performance improvement initiatives to ensure national, state and agency regulatory compliance. Works with clinicians and administrators to improve patient safety and systems-level outcomes.

EMRs were built as billing support tools and evolved into medical data repositories. Nuanced data of clinical importance can be difficult to access and currently requires dedicated technical personnel with specific skills to partner with clinical staff in a laborious approach to extract specific data. Today, there are no EMR-integrated platforms or other third party vendors that capture or display a hospital’s feeding protocol in a structured way. Because of this, protocols currently require intense manual calculations to determine care delivery and furthermore a patient’s actual daily feed intakes cannot be easily overlaid on what should be delivered to confirm compliance or adherence with absolute certainty. Neonatologists and dieticians extract data retrospectively in a highly manual way to evaluate the effectiveness of delivered nutrition and care on a preterm infant’s growth. These approaches suffer from laborious data collection, data inconsistencies, and time for reporting. Additionally, limitations in data collection and analysis techniques have prevented hospitals from developing a better understanding of how to translate real-world evidence into effective interventions that could improve health outcomes for all. NICUtrition Bedside Support Tool (BeST Practices) liberates critical data that is currently elusive or lies outside standard EMR APIs, such as “flow sheets”, which remains unavailable without the dedication of technical resources and skilled clinicians.