Collaboration and Competency Criteria Key to Addressing Neonatal Provider Workforce Challenges

With collaboration among neonatal intensive care unit (NICU) providers increasingly important, a new American Academy of Pediatric technical report outlines the training and practice scope of different professionals who care for high-risk, hospitalized newborns. The "Neonatal Provider Workforce" report in the December 2019 Pediatrics (published online Nov.18) also suggests ways to establish and monitor quality and safety of care, as well as potential solutions to current and future NICU provider workforce shortages. Accreditation Council for Graduate Medical Education changes to how many consecutive hours physicians-in-training can work has limited the availability of pediatric residents to care for patients in the NICU. As a result, much of the care provided in NICUs has shifted from residents onto other providers, such as pediatric hospitalist physicians, neonatal nurse practitioners (NNPs), and physician assistants (PAs). At the same time, a growing national shortage of NNPs and insufficient numbers of PAs and pediatric hospitalists practicing in neonatal intensive care challenges many programs' abilities to adequately staff their NICUs. Some are using various providers in different roles across NICU settings. The AAP outlines ways that could help address provider workforce shortage and reduce the workload to improve outcomes and decrease provider "burn out." It also recommends developing and periodically reviewing competency criteria for all NICU providers, perhaps using the well-established training model for NNPs, to ensure high-quality, safe, and cost-effective care.

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.