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  • COCOON logo

    COCOON is the new model of care in Newborn Intensive Care Unit (NICU) and Special Care Unit (SCU) on Butterfly at The Royal Children's Hospital, Melbourne (RCH). We have compiled lots of important information to help you engage with your baby right from the start, and ultimately prepare you to leave Butterfly feeling confident as a parent.

    What is COCOON?

    COCOON stands for "Circle Of Care Optimising Outcomes for Newborns". It is the name of the new model of care on Butterfly. "Model of care" means the approach to how care is delivered in healthcare settings, such as hospitals or individual wards. The name COCOON was chosen to symbolise the support and mentoring our staff can provide to help you engage with your baby in the best ways possible.

    The main aims of COCOON are:

    • To improve health outcomes for newborn babies
    • To improve the experience of families whose babies are cared for on Butterfly

    We will provide you with lots of information and education while you and your baby are with us. Some of this is general information about the community, the hospital, and the ward. However, the COCOON education package is designed to teach you about how to care for yourself and your baby. You will find practical guides on how to change nappies and bath your baby, photos of different feeding techniques, and lots of other information on how to recognise your baby's behaviours and interpret their cues, all of which will enable you to engage with your baby in a really positive way.

    How was it developed?

    COCOON was developed over a two year period by a project team made up of doctors, nurses and allied health professionals. The team consulted widely with all staff groups working in Butterfly. We asked parents who had babies in the unit at the time to tell us about their experiences, and we also met with parents who had babies in the ward in the past to give us feedback. In addition, we reviewed lots of evidence from scientific studies to get the best and most up-to-date ideas about models of care that work.

    We received a lot of support from other departments within RCH to help with the design and implementation of COCOON, such as the Creative Studio, who built the My RCH app; the Quality and Safety team who helped us recruit parents to fine-tune the app and its content; and the RCH Executive who offered their full support to the introduction of a new model of care.

    Why did we bother?

    This is a good question. We are proud to say that we have been delivering excellent care to babies and their families for a long time. However, there are many reasons why we should always be working harder to improve outcomes for babies and families.

    To start with, the old days where patients or families were simply told what treatments or care they would be getting are gone. These days, people have more access to information about health, and patients and families expect to be involved in discussions and decision-making, supported by the guidance and expertise of their health care team.

    Seeing patients and their families as partners in care is one of the central principles of Patient and Family Centred Care (P&FCC). The RCH fully supports this model of care and you can see this shining through in the RCH Values:

    • Unity: we work as a team and in partnership with our communities
    • Respect: we respect the rights of all and treat people the way we would like them to treat us
    • Integrity: we believe that how we work is as important as the work we do
    • Excellence: we are committed to achieving our goals and improving outcomes

    Studies in adult hospitals have shown that the continuity provided when patients and families are engaged as partners in care has positive effects on clinical outcomes such as the management of long-term conditions, reduced anxiety and stress, and shorter hospital stays for patients. We believe that positive effects will be seen if families are engaged in their newborn baby's care as early as possible.

    The adverse effects of separation and intense stress experienced by parents of a sick or premature infant have been well documented. They are known to cause high levels of psychological distress, including anxiety, depression and post-traumatic stress disorder in families in the short- and long-term, and impair ongoing brain development in children.

    "Care-by-parent" studies have reported better cognitive development, improved mother-infant interaction and attachment, reduced parenting stress, less maternal depression and anxiety, and a reduction in extra illnesses in the babies who were studied in hospital. In addition, these studies have also reported less mistakes in hospital, shorter hospital stays for babies and increased staff satisfaction for doctors and nurses looking after the babies if their parents are supported to be heavily involved as partners in care.

    In summary, babies are born ready to connect, engage and learn. This may be disrupted by illness and separation, but can still be nurtured. Illness and separation may cause increased stress and anxiety on the infant and their family, and this has been proven to affect brain development and subsequent neurodevelopmental progress in childhood. Therefore, it is essential that every effort is made to nurture the parent-infant bond by encouraging families to interact with their babies as much as possible, from as early as possible. This is why COCOON was developed.

    The Key Principles that form the central ethos of COCOON, which have been developed in consultation with families and staff, are as follows:

    • The concept of seeing the baby as a person with the ability to communicate, initiate and respond to their environment and caregivers, should underpin every thing we do, every day.
    • Outcomes for babies, families and staff should be optimised by delivering world-class patient-centred, family-integrated, baby-led care.
    • Communication between staff, parents and babies should be prioritised to ensure appropriate knowledge and skills are shared.

    And in short …

    The COCOON mission is to place the baby and family at the centre of every thing we do, every day.