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  • Original Article
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Thematic analysis of barriers and facilitators to implementation of neonatal resuscitation guideline changes

Abstract

Objective:

To evaluate experiences regarding implementation of Neonatal Resuscitation Program (NRP) guideline changes in the context of a collaborative quality improvement (QI) project.

Study Design:

Focus groups were conducted with local QI leaders and providers from nine sites that participated in a QI collaborative. Thematic analysis identified facilitators and barriers to implementation of NRP guideline changes and QI in general.

Results:

Facilitators for QI included comparative process measurement and data tracking. Barriers to QI were shifting priorities and aspects of the project that seemed inefficient. Specific to NRP, implementation strategies that worked involved rapid feedback, and education on rationale for change. Changes that interrupted traditional workflow proved challenging to implement. Limited resources and perceptions of increased workload were also barriers to implementation.

Conclusion:

Collaborative QI methods are generally well accepted, particularly data tracking, sharing experience and education. Strategies to increase efficiency and manage workload may facilitate improved staff attitudes toward change.

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Acknowledgements

We thank the participants of the CPQCC Delivery Room Management Collaborative that also took the time to provide the insightful and valuable data that formed the basis for this study. The project described was supported by Grant Number K23HD068400 from the Eunice Kennedy Shriver National Institute of Child Health & Human Development and a grant from the NRP (American Academy of Pediatrics). The content is solely the responsibility of the authors and does not necessarily represent the official views of the Eunice Kennedy Shriver National Institute of Child Health & Human Development, the National Institute of Health, NRP, or the American Academy of Pediatrics.

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Correspondence to H C Lee.

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Lee, H., Arora, V., Brown, T. et al. Thematic analysis of barriers and facilitators to implementation of neonatal resuscitation guideline changes. J Perinatol 37, 249–253 (2017). https://doi.org/10.1038/jp.2016.217

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