Neonatal Intensive Care - Vol. 37 No. 3 Summer 2024 - The NICU Discharge Dilemma

Sep 13, 2026

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The transition from the NICU to home is a high-stakes discharge dilemma requiring both clinical readiness and family emotional preparedness to ensure safe newborn care. The current process is often hindered by staffing shortages, fragmented communication, and paper-based or outdated tracking of discharge criteria, which can reduce health education effectiveness, prolong hospitalization, and delay follow-up coordination. Using the Jobs to be Done (JTBD) methodology, the paper analyzes common discharge challenges and survey gaps, outlining how technology can support care teams and empower families.

LanguageEnglish

CategoryPresentations

FormatPDF

Pages6

Reading Time2 min

AccessFree to download

Introduction

Jobs to be Done Methodology

User Roles in Supporting the Transition from NICU to Home

neonatal INTENSIVE Vol. 37 No. 3 Summer 2024 CARE The NICU Discharge Dilemma: How Leveraging Technology Can Support Care Teams, Empower Families, and Measurably Improve the Discharge Process Jaylee Hilliard, MSN, RN, NEA-BC, CPXP, Marissa Koscielski, MS, Andrew Fiedler, BA, CCP, LSSYB Introduction The transition from Neonatal Intensive Care Unit (NICU) to home represents a critical juncture in the continuum of care for newborns, their families, and their healthcare providers. This period often termed the “healthcare discharge dilemma,”involves a complex set of challenges that includes a patient whois medically ready for discharge and an emotionally prepared family who has demonstrated the knowledge and skills to care for their baby safely at home. While the NICU’s highly specialized and supportive environment meets the infant’s immediate medical needs, it vastly differs from the home setting, where families must assume full responsibility for the infant’scare. To prevent high rates of emergency department visits andreadmissions after discharge from the hospital, a family must feel confident in their competence level to care for their baby’s specific medical needs. A safe and successful discharge includes a multidisciplinary team approach. Coordinating the busy day-to-day patient caseloads while ensuring clear, consistent communication throughout the NICU stay adds complexity to the process. Discharge planning varies widely across NICUs, often relying on outdated methods to track critical discharge criteria and milestones. Healthcare staffing shortages and inconsistent patient care providers further complicate the process. This often leads to triangulated and ineffective patient communication among healthcare team members and necessitates reliance on paper-based or less efficient methods to keep the care team aligned and informed. Such practices negatively affect the quality of education the family receives, prolong hospital stays, and delay coordination in follow-up care. Educating families and training them for home care is often compressed into the 48 to 72 hours before discharge, placing substantial pressure on the healthcare workers and leaving families ill-equipped to care for their infants at home safely.1 These challenges are further intensified by data showing that 43% of NICU parents have low levels of health literacy and that regardless of health literacy levels, parents were unable to retain 80% of care instructions given to them before discharge.2,3 The challenges are further intensified by a shortage of clinical staff and fragmented communication among healthcare professionals and families, Jaylee Hilliard, MSN, RN, NEA-BC, CPXP, is the Senior Director of Clinical Strategy at AngelEye Health, revolutionizing patient and family support through advanced technology. With extensive experience in nursing leadership and NICU parenting, Jaylee drives product innovation, supports healthcare leaders, and empowers hospitals to achieve the quadruple aim. which leads to misunderstandings and delays and places the infant’s overall well-being at risk. This paper introduces the common discharge challenges in healthcare and presents survey data on the significant gaps in the current discharge process, utilizing the Jobs to be Done (JTBD) methodology.4 The need to leverage technology with solutions that support care teams and families with a successful, efficient, and safe transition to home from the NICU will also be reviewed. Jobs to be Done Methodology The Jobs to be Done (JTBD) framework is a research and product development methodology that deploys a user-centric approach that shifts the focus from the product’s features to amore comprehensive understanding of the individual’s needs and what drives their behavior. Underpinning the JTBD framework is a set of core tenets that collectively build a foundation upon which organizations build a sustainable practice of innovation.5 By identifying unmet

FAQs

Why is NICU discharge considered a dilemma when moving to home care?

NICU discharge involves a medically ready infant and an emotionally prepared family able to safely manage the baby’s specific medical needs. Home care differs substantially from the NICU’s support, increasing the risk of misunderstanding or delays.

What shortcomings in current discharge planning are highlighted?

The process often relies on outdated methods for tracking discharge milestones, suffers from staffing shortages, and uses paper-based approaches that lead to ineffective communication. These issues can impair family education, extend hospital stays, and delay follow-up care coordination.

How does the Jobs to be Done (JTBD) methodology support the paper’s approach?

JTBD focuses on user needs and the drivers of behavior rather than product features alone. By identifying unmet functional, emotional, and social determinants behind decisions, the framework helps develop solutions that complete the discharge-related “job” more accurately and efficiently.

Sep 13, 2026

Uploaded by Sage