Saturday, July 14, 2007
This presentation is part of : Outcome Measurements
Combining the JCAHO Core Measure Concept with Reliability Science for Measurable Success in Developmentally Supportive Care
Mary E. Coughlin, RN, MS, NNP, Education, Children's Medical Ventures, Norwell, MA, USA
Learning Objective #1: list the 5 evidence-based core measures of developmentally supportive care.
Learning Objective #2: describe the principles of reliability science as it applies to the healthcare environment.

Developmentally supportive care in the newborn intensive care unit has been described in the literature to encompass a myriad of variables which include pain and stress management, supportive positioning, environmental modifications, individualized oral feeding strategies, within a family-centered care context. Despite the burgeoning body of evidence for developmental care from multiple disciplines, clinical application, implementation, and the actual definition of what comprises developmentally supportive care remains inconsistent. In addition to this challenge, newborn intensive care units that profess a developmentally supportive care practice model have difficulty ensuring consistent delivery of this standard of care. Identifying developmentally supportive care practices that are validated by evidence-based research and integrating this knowledge into a performance measurement system similar to the JCAHO core measure concept, provides the foundation for standardization of developmentally supportive care delivery in the newborn ICU. This construct provides for consistency in the interpretation and clinical application of developmental care as well as creating a framework for the comparative analysis of developmental care practices and clinical outcomes related to developmental care across multiple healthcare systems. Recognition and acceptance of the core measures for developmentally supportive care becomes the platform to measure performance and begin to operationalize the practice standard utilizing reliability science. Designing reliable processes around acknowledged standards of care and performance measures is aimed at ensuring that 95% or more of the patient population receive the standard of care. This degree of reliability in practice impacts infant and family outcomes, staff satisfaction, and organizational, third-party payer, and societal costs related to the intensive care experience. Evidence-based core measures of developmentally supportive care with an emphasis on process improvement through the application of reliability science are the focus of this presentation.