The advancement in life-saving technologies and clinical expertise in the care of extremely
premature infants, have resulted in the development of large neonatal intensive care units
(NICU). It has been suggested that reconstruction of megaunits of neonatal intensive care to
smaller care units with specific patient population and clinical team providers will be
essential to maintain optimal teamwork, quality of care and patient outcome.
Despite the growing knowledge around the need for reconstruction of large NICUs to smaller
units of care, there is no evidence regarding the safety and efficacy of microsystem model of
care on the key aspects of health care. At the McMaster Children's Hospital (MCH), we planned
a change from standard model of care to the microsystem model of care and therefore we aimed
to prospectively assess the effect of this organizational change on the variable aspects of
A working group met weekly to formulate the implementation planning, to review the adaptation
and adjustment process and to ascertain the quality of implementation following the
initiation of the microsystem model.
The study was retrospectively registered.