A project funded by the NIHR HS&DR Programme, looking at preparing parents for returning home with their new baby, has just published in Health Services and Delivery Research. 

Read the full report. 

More than 90 percent of babies born at 27 weeks or more gestation survive and are later discharged to go home. Many of these will have stayed in Neonatal Intensive Care and in High Dependency and Special Care units.

Many parents returning home can feel unprepared and lack the confidence to care for their baby. They often find themselves seeking emergency and out of hours care.

A project lead by Professor Peter Fleming and Dr Jenny Ingram, of the University of Bristol, examined the effects of implementing parent-oriented discharge planning, known as the Train-to Home intervention. This aimed to increase parents’ confidence in caring for their baby, reduce hospital stay and lessen the use of healthcare services after discharge. It involved estimating the likely discharge date and displaying it on a train graphic with five labelled carriages: breathing, feeding, growth, temperature and sleeping. Parents were given gestation specific leaflets with questions to discuss with staff based on the five labels to help improve their preparedness for returning home.

The researchers recruited parents of babies born between 27 and 33 weeks from four neonatal units in South West England. They found that parents who received the intervention understood their baby’s needs better and there were fewer visits to Emergency Departments after going home. As a consequence, the costs of care after discharge from hospital were reduced.

“Any increase in parental confidence to care for their baby could reduce their length of stay in hospital and possibly reduce healthcare resource use after discharge, making potentially significant healthcare savings” commented Professor Fleming. “Our research shows that Train-to-Home can contribute to family-centred care.”

Read the full report in Health Services and Delivery Research.