Abstract
Changes in neonatal intensive care unit (NICU) coverage models, restrictions in trainee work hours, and alterations to the training requirements of pediatric house staff have led to a rapid increase in utilization of front-line providers (FLPs) in the NICU. FLP describes a provider who cares for neonates and infants in the delivery room, nursery, and NICU, and includes nurse practitioners, physician assistants, and/or hospitalists. The increasing presence and responsibility of FLPs in the NICU have fundamentally changed the way patient care is provided as well as the learning environment for trainees. With these changes has come confusion over role clarity with resulting periodic conflict. While staffing changes have addressed a critical clinical gap, they have also highlighted areas for improvement amongst the teams of NICU providers. This paper describes the current landscape and summarizes improvement opportunities with a dynamic neonatal interprofessional provider team.
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Data from the ONTPD survey which are referenced in this article are available at: https://collaborate.aap.org/SONPM/_layouts/15/WopiFrame.aspx?sourcedoc=%7B62FB95B2-38A3-4155-B67B-40DAD51D9B8B%7D&file=2022%20ONTPD%20Annual%20Report.pdf&action=default.
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MS conceptualized this project and convened the interprofessional working group. NFD, ELK, PM, KM-A, MSL, LCJ, KR, and MS drafted the initial manuscript. All authors critically reviewed and revised the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.
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Dyess, N.F., Keels, E., Myers, P. et al. Optimizing clinical care and training in the neonatal intensive care unit: the relationship between front line providers and physician trainees. J Perinatol 43, 1513–1519 (2023). https://doi.org/10.1038/s41372-023-01749-7
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DOI: https://doi.org/10.1038/s41372-023-01749-7
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