Carter et al. - 2017 - Systematic Changes to Help Parents of Medically Complex Infants Manage Medical Expenses

Last modified by Hendrick Guerra on 2019/04/11 20:30


Carter et al.





United States


Journal Article - Quality Improvement Study


Determine whether timely  referrals of parents (with primary health insurance) to health benefits coordinators (HBCs) would increase utilization of the program by parents in the NICU

Key Notes/Findings:

  • By using the PDSA (Plan-Do-Study-Act) framework, the referral system was revised
  • Changes made to the referral process:
    • A bedside nurse–initiated screening tool was developed that would rapidly trigger an evaluation by the social worker, nurse case manager, and HBC
    • A letter informing parents was placed in every admission packet
    • Meet and greet sessions were established between parents and HBCs
    • Staff education
  • Pre implementation data showed that less than 5% of eligible NICU parents received a referral
  • After 4 years post implementation, referrals gradually increased  from 13% to an average of 90%


Carter J, Dwyer N, Roselund J, Cote K, Chase P, Martorana K, et al. Systematic Changes to Help Parentsof Medically Complex Infants Manage Medical Expenses: Advances in Neonatal Care. 2017 Dec;17(6):461–9. Available from:

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