NeoHOME: Innovation in care location for Queensland’s smallest humans

Where and how we care for preterm babies in South-East Queensland requires urgent review. Increased demand for service, improved survival rates, increased complexity of premature and sick newborns and a specialist nursing shortage has seen burgeoning pressure on large tertiary units, such as ours: The Grantley Stable Neonatal Unit (GSNU) at the Royal Brisbane and Women’s Hospital (RBWH). Emerging evidence indicates that early discharge of physiologically stable, pre-term neonates is safe and cost-effective when appropriate in-home supports are in place (Brooten 1986; Cruz 1997; Collins et al, 2015). Given the comfort and psychological safety of the home environment, we anticipated enhanced parent-infant bonding. Health system level improvements, such as increased capacity within the Neonatal Unit would also result if we adopted similar models.

In late 2021, the Women’s and Newborn Service, Hospital in the Home project (NeoHOME and MatHOME) was successfully granted SEED funding from the Metro North Hospital and Health Service (MNHHS) Innovation Program. With their support and guidance, two arms of the project were developed (maternity and neonatal) and NeoHOME was born. The objectives of NeoHOME are:

• safe and effective care in the home for preterm neonates
• improved parental satisfaction, wellbeing and self-efficacy in addition to reduced financial burden, associated with long-term hospitalisation
• reduction in occupied bed days with anticipated improvements to capacity and staffing demands

Clinical implementation commenced 4-months ago, and 61 neonates have been cared for in the home.