Newborn news, delivered each morning at Packard Children's

Courtesy of Lucile Packard Children's Hospital neonatal newborn at Lucile Packard Children's Hospital

A daily printout for parents containing key information about their newborn's condition is placed next to the baby's bedside each morning in the neonatal intensive care unit at Lucile Packard Children's Hospital.

Parents of sick newborns need clear, immediate access to information about their baby's condition. While conversations with the physician or nurse are a key source of information, Packard Children's Hospital has found another way to keep moms and dads in the loop.

When the hospital's neonatal intensive care unit switched from paper-based files to electronic medical records, it became easier for caregivers to maintain and share medical information with each other. The next step was to extend this information to vital members of the care team: parents.

A group of physicians, nurses, parents and informatics specialists designed a template that is printed out each morning and placed by the baby's bedside. The printout, called "Your Baby's Daily Update," provides a snapshot of key items from the electronic medical record, including the members of the care team, lab results, nutritional status and any changes over the past 24 hours. The printout has room at the bottom for the nurse or physician to leave a hand-written update or personal note.

"The team had a good sense of what needed to be included on the printouts based on what parents wanted to know about their child each day," said Jonathan Palma, MD, MS, a neonatologist and member of Packard Children's medical informatics services. "The update empowers parents with the knowledge to contribute to medical decision-making regarding their infant and creates a meaningful connection."

When Shannon Maher's son Aiden Kuwayti was born 10 weeks early, the updates helped Maher communicate with her husband about the baby's condition. Because the couple had an older child at home, they took shifts at Aiden's bedside, catching each other up on his condition by phone. But the stress of Aiden's fragile state made it difficult for Maher to recall specific details of his care. Instead, she gave her husband information from the printed updates each time they talked. "It really helped to have some numbers to give him," she said.

Since it was introduced in 2010, the update has been translated into Spanish and the distribution process has been expanded and streamlined. Based on the NICU's experience, other Packard Children's departments are beginning to offer similar updates for the families of their patients, too.

"The update includes all the basics that a parent wants to know and is a starting point for more in-depth conversations," said Heather Keller, a parent lead in the Department of Family-Centered Care and a member of the team that developed the project. "It's also a wonderful tool for parents new to the NICU who face a tremendous learning curve about their child's care and condition."

In a scientific study designed to evaluate "Your Baby's Daily Update," parents reported that they found the printout very useful, and more than 95 percent said that they "always" liked receiving it and felt more competent to manage information related to the health status of their babies. Parents rated the quality of the update as highly as information from their conversations with doctors and nurses, and more highly than many other information sources, such as NICU bulletin boards or the Internet. Many considered the report to be "refrigerator worthy," taking it home for display, as well as posting it on family blogs and Facebook. The study was published in the Journal of Participatory Medicine in December 2012.

Shannon Maher saved all of Aiden's updates in a special folder at home. She sometimes looks at them as a reminder of his first fragile weeks, which present a marked contrast to the healthy, active toddler Aiden is now.


Stanford Medicine integrates research, medical education and health care at its three institutions - Stanford University School of Medicine, Stanford Health Care (formerly Stanford Hospital & Clinics), and Lucile Packard Children's Hospital Stanford. For more information, please visit the Office of Communication & Public Affairs site at http://mednews.stanford.edu.

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