Research and Evidence

Merge™ was tested in a cluster randomized controlled trial in 10 Level II neonatal intensive care units (NICU) with 654 mothers and 765 infants. We found:

• A 2.55-day reduction in moderate and late preterm infant hospital length of stay favoring Merge™ 

  • No concomitant increases in emergency department visits or hospital readmissions. 

• Mothers were less distressed 

• Mothers were more confident in the care of their infant

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Did you know it normally takes 17 years for an idea about how to improve healthcare to be put into practice? 

 

We present Merge™ as a case study of value-based health care optimized through a learning health system framework. Value-based health care is a way of organizing health systems to transform outcomes and achieve the highest quality of care and the best possible outcomes with the lowest cost. With predictable processes and structures to facilitate evidence to implementation and finally sustainability, Merge™ realized a positive return on investment, creating $1.16 million in value over 2 years for the Alberta health system by freeing up costly NICU capacity through length of stay reductions. 

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Neonatal intensive care units (NICUs) are highly technological critical care environments that can be overwhelming for parents during an already stressful time. 

 

We explored mothers’ experiences of parenting in the NICU grouped by model of care (Merge™ and standard care). A core social process of Journey to Home was identified. 

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Merge™ is an actionable model of family integrated care that empowers parents to partner with the healthcare team in the care of their infant, from the time of admission. 

 

With Merge™, infants were first placed skin-to-skin earlier, achieved full enteral feeds more quickly, and spent less time on Total Parental Nutrition. 

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The complexity of health systems interferes with good intentions and capacity to provide family centered care. 

 

Prior to evaluating Merge™, healthcare providers and hospital administrators from 10 level II NICUs told us about how they needed to direct their efforts to meet requirements of the health care system. In addressing requirements of the health care system, providers lost sight of family centered care and patient outcomes.

 

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Upon admission of their infant to the neonatal intensive care unit (NICU), fathers have reported shock and anxiety, a general sense of lack of control, difficulty transitioning into fatherhood as a result of the critical care needs of their infant, and a lack of information exclusive to them.

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With Merge™, fathers attributed their level of confidence and positive NICU experience, which continued post-discharge, to the care and attention they received during hospitalization.

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