Mass intrahospital transport of the neonatal intensive care unit: a systems-based approach to safety, efficiency, and family-centered care

Abstract Objective To design and evaluate a systems-based approach for safe, efficient, and family-centered mass intrahospital transport (M-IHT) of critically ill neonates during two planned NICU relocations. Methods This prospective QI initiative followed SQUIRE 2.0 guidelines. Work system design was guided by systems-based patient safety frameworks, Operations/Management Science principles, integrating context evaluation with proactive, multidisciplinary, simulation-based planning to mitigate risk and ensure real-time adaptability. Outcomes were evaluated using prospectively collected multi-source data. Results Both relocations were completed without clinical complications, equipment failures, or service disruption. Staff surveys showed >90% positive responses across domains. Parents reported high satisfaction, perceived safety, and effective communication. Direct observations confirmed smooth coordination, role clarity, workflow adherence, and real-time responsiveness. The work system was successfully reapplied with consistent performance and improved efficiency. Conclusions M-IHT of critically ill infants was conducted safely and efficiently using a reliable, adaptable, and sustainable system-based framework offering transferable lessons for complex operations.