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Family Integrated Care: changing the culture in the neonatal unit
  1. Neil Patel,
  2. Ainsley Ballantyne,
  3. Gillian Bowker,
  4. Jack Weightman,
  5. Sarah Weightman
  6. for the Helping Us Grow Group (HUGG)
  1. Department of Neonatology, Royal Hospital for Children, Glasgow, UK
  1. Correspondence to Dr Neil Patel, Department of Neonatology, Royal Hospital for Children, Glasgow G51 4TF, UK; neilpatel1{at}nhs.net

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Introduction

Family Integrated Care (FIC) is a new model of neonatal care which supports parents to be primary caregivers, as partners with the clinical team.1

The inspiration for FIC comes from lower resource settings where families provide care through necessity rather than choice.2 3 This approach has been adapted for modern neonatal intensive care by pioneering FIC teams in Canada, Scandinavia and the UK. Trials in preterm infants have demonstrated improved rate of weight gain, reduced parental stress and shorter length of stay.4 5 By supporting and combining the benefits of breast feeding, kangaroo mother care (KMC) and parental presence, FIC may have even greater long-term benefits for infants and their families.6

FIC builds on the foundations of Family-Centred Care, a well-established approach with accepted standards supported by Unicef and the neonatal charity Bliss.7 8 FIC takes parental involvement to a new level placing families at the centre of care and empowering them as primary caregivers (table 1).

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Table 1

Comparison of FCC and FIC at RHC, Glasgow

Though the concept of FIC is intuitive and the potential benefits compelling, delivering this model of care may be challenging. We took on this challenge in our neonatal unit, the largest unit in Scotland with approximately 1000 admissions per year and over 200 staff. Our patients include extremely preterm infants as well as those requiring specialist medical and surgical care including extracorporeal membrane oxygenation (ECMO). Implementing FIC in a unit of this size and diversity has its own specific challenges, but has been hugely rewarding. In this article, we share our approach and lessons learnt, and describe the transformative effect on families and staff.

The challenges of implementing FIC

FIC means not just physically involving families, but equally importantly changing the culture and relationships with staff.9 10

Staff engagement is potentially the greatest challenge. FIC requires a …

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