Feasibility and Acceptability of a Neonatal Project ECHO (NeoECHO) as a Dissemination and Implementation Strategy to Prevent Necrotizing Enterocolitis

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Background: Caregivers in the neonatal intensive care unit (NICU) often determine care practices in silos, although access to learning communities can improve quality. Project ECHO, a telehealth– delivered mentoring intervention, provides specialists’ expertise but not in the NICU until now. Necrotizing enterocolitis (NEC) prevention and timely recognition is one area where specialist support and engaging with a learning community could improve outcomes. NEC- Zero is one care bundle that aims to improve care quality by providing tools to implement NEC prevention in family- engaged ways. Aims: To examine the feasibility and acceptability of NeoECHO to disseminate NEC- Zero education and describe the intentions of internal facilitators (IFs) and clinicians to initiate quality improvement changes. Methods: This was a convergent mixed- methods study. Our team delivered the first neonatal adaptation of Project ECHO called “NeoECHO” to leverage facilitation as an implementation strategy to disseminate NEC- Zero evidence and support practice change. Results: Six IFs and seven NICUs participated. All units and IFs that began the series finished it. Of the 261 session attendees, 206 (79%) study evaluations were completed. Of those who completed evaluations, 89 (100%) completed at least one session and 29 (33%) completed three or more. Satisfaction was high. Participants appreciated the engaged and accessible format to learn from experts using real case examples and didactic sessions. Individuals and IFs reported intentions to adopt evidence based on NeoECHO. Linking Evidence to Action: NeoECHO was an acceptable and feasible way to engage under- resourced NICUs and share NEC- Zero evidence and tools. More research is needed to examine the impact of NeoECHO on care processes and patient outcomes