Flexible Nurse Deployment Could Significantly Reduce Neonatal Transfers in the Netherlands, Study Finds

Flexible Nurse Deployment Could Significantly Reduce Neonatal Transfers in the Netherlands, Study Finds

(IN BRIEF) Researchers from the University of Twente, in collaboration with Amalia Children’s Hospital Nijmegen and Emma Children’s Hospital Amsterdam, have developed a solution to reduce the number of neonatal transfers in the Netherlands. Their study suggests that by allowing NICU nurses to work flexibly across the national network, the number of patient transfers could decrease by up to 70%. This approach focuses on optimizing nurse deployment rather than moving babies, particularly in high-demand regions like Randstad. The researchers propose testing the approach with a pilot project to improve care quality and reduce strain on both medical staff and parents.

(PRESS RELEASE) ENSCHEDE, 7-Mar-2025 — /EuropaWire/ — Each year, approximately 600 babies in the Netherlands are transferred to another Neonatal Intensive Care Unit (NICU) due to capacity issues. In an effort to address this challenge, researchers from the University of Twente’s CHOIR research centre, the Amalia Children’s Hospital Nijmegen, and the Emma Children’s Hospital Amsterdam have developed an innovative solution. Their study suggests that by allowing NICU nurses to work flexibly across the national NICU network, the number of neonatal transports could be reduced by up to 70%, potentially eliminating at least one transport per day.

Although the Netherlands overall has enough NICU capacity to provide this critical care, babies are often transferred when one NICU reaches its full capacity. These transfers not only cause logistical complications but also present health risks for the newborns and increase the distance between the child and their parents. Gréanne Leeftink, the study’s lead author, notes, “The physical capacity of NICUs is usually not the problem, but the shortage of specialized nurses.”

Flexibility in staffing could drastically reduce these patient movements. According to the research, published in Health Care Management Science, by deploying nurses flexibly, a significant number of transfers can be avoided. “A little flexibility in staff allocation can prevent most patient movements,” says Leeftink, with the approach proving particularly successful in the densely populated Randstad region of the Netherlands.

The findings indicate that only 15% of NICU nurses need to be available at multiple locations during part of their shifts, and this flexible staffing strategy would apply to only 3-4% of the services. “Through collaboration and flexible staffing, we can optimize the use of available capacity,” Leeftink explains. The research team recommends a pilot project to test this approach in real-world settings, which could improve care quality and reduce the strain on both parents and medical staff.

To determine the best way to implement flexible staffing, the researchers explored various strategies. The most effective method involved allowing nurses to be deployed to all NICUs, which would significantly reduce patient transfers but require substantial flexibility from the staff. Alternatively, pairing NICUs together in pairs was a more stable option, reducing the number of transports to a lesser extent but offering shorter travel times and more predictable staffing arrangements.

This research builds upon the graduation project of UT alumna Kimberley Morris, who earned the 2022 Graduation Award from the BMS faculty for her work on this topic. Dr. Gréanne Leeftink, associate professor at the CHOIR research group (TechMed Center), collaborated with Prof. Erwin Hans, a professor of operations management and CHOIR co-founder, along with Drs. Tim Antonius of the Amalia Children’s Hospital and Willem de Vries of the Emma Children’s Hospital to further this investigation.

The findings of the study were published in the Health Care Management Science journal, titled “Inter-organizational pooling of NICU nurses in the Dutch neonatal network: a simulation-optimization study,” and the article is available online as open access.

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SOURCE: University of Twente

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