Assessment for improving the performance of NICUs: The Italian experience.

This paper describes neonatal intensive care units (NICU) in Italy using a set of organizational variables identifying management profile. The correlations between variables, and how these are impacted by structural aspects of the department or hospital, are investigated. The research was conducted within the 5-year far-reaching and complex SONAR study run by the Italian Neonatal Network, which maps NICU, monitors outcomes of member centres, defines organizational models, and identifies best practices to improve care quality. Seven variables relating to activities, organization processes, and behaviour models used in the SONAR study were used here to assess NICU. Data from 54 Italian NICUs, 1601 nursing staff, and 643 doctors were used. We identified high levels of variation in NICUs for all aspects of organization. We also identified important opportunities for improvement, especially in the areas of performance measurement, quality improvement, and learning for healthcare staff. In terms of structural characteristics, we identified big differences between NICUs in the north and south of Italy. The findings provide a description of NICUs in Italy and identify a set of variables useful for management in assessing NICU, which are among the most complex and costly operational units in a hospital.