Care for sick newborns is planned and provided by a multidisciplinary team that consists of nurses, paediatricians, medical and clinical officers, nutritionists as well as parents. To facilitate team communication, care planning and follow up, job aids such as charts are required. However, previous research showed that post admission documentation was suboptimal making it difficult to use the documentation for quality improvement and tracking how babies were progressing during admission.

On examining existing monitoring charts, we discovered that they did not meet the needs of the care team leading to suboptimal documentation of care. We adopted a Human-centered design which is an approach that puts the user at the heart of the design. The approach helped us understand the problems with documenting monitoring care and together with nurses and paediatricians designed two monitoring charts. The design sessions were conducted over 3 workshops between March and June 2019. One chart was to be used on babies requiring 3 to 6 hourly monitoring and another was to be used for babies requiring closer monitoring.

These two charts were piloted at 4 hospitals in the network between June 2019 to February 2020 with a view to understand how they are used in the real-world setting. We received feedback and modified the chart to consolidate it into one comprehensive newborn monitoring chart which can be used flexibly. In July 2020, we launched the chart virtually in the network and has been in use in many facilities to date.

Initial follow up reports on how implementation is progressing at the hospitals show that health workers appreciate the new charts. They report that it makes work easier as all information can be found on one page: it’s a one stop shop. They appreciate that it makes it easier to track progress, there are less papers to write on, find information required for clinical audits and handover as well as facilitate team communication. These benefits have been realised because the team leaders (nurses and paediatricians) played a key role in supporting implementation by continuous training, supervision, working as a team and removing old charts.