Inside the NICU

Kangaroo Throw Down … We have a WINNER!

At long last, we have the results of our Kangaroo Throw Down, which means we can now declare a winner!  

The truth is that every single hospital and every single team member who participated in this challenge, with such passion and commitment, can be considered a winner. You are all so inspiring!  Your families and babies thank you for your compassionate care. Next week we will share some tips and stories from many of the participating hospitals, and some of the beautiful pictures that have been shared with us. 

However, for now we will focus on one hospital who did rise above to claim the top prize for this year [drum roll please ….]

The NICU at Salem Hospital in Salem, Oregon!

This amazing team worked together to achieve 2.56 hours of holding per baby per day. That is a fantastic total, and a lot of hard work went into achieving it.  


We asked this team why they thought they won, and what tips they might have for other units who want to improve their kangaroo care or skin to skin holding rates. As befits a champion, they had excellent advice to share with us all.  In their own words …

Why did we win? 

We took a QI approach.
We have a team.
We had a SMART AIM:  to have an average skin to skin time of 2.5 hours per baby per day during our two week Kangaroo “Throw Down” from 5/4-5/17/2015.
We identified key drivers: look at/know/share your data, awareness/ visibility, engagement of all caregivers and families, small rewards, understanding importance/rationale of skin to skin.
We measured daily.


We marketed it beforehand in multiple ways.
Everyone knew our goal was 2.5 hours/baby/day.
We discussed it at daily huddles.
It was on our visibility window.
We planned celebrations during it.
We had daily small drawings for prizes and a larger reward at the end.
We all knew that we were competing with other NICUs.

We made our results very visible.
We sent daily emails with how we did each day.
Run Chart updated daily in the Nurse’s station and pointed out during huddle.

We celebrated.
We combined Kangaroo Care, Nurses’ Day, Mother’s Day Cake and Coffee Bar.
We held a Pocket Sandwiches Day.
Kangaroo gifts for families.
Daily raffle/prizes for staff  and overall end of event raffle prize for staff and NICU families.

We have a long-standing focus on parents/babies doing skin to skin.
Early on we had a nurse and physician champion.
Our QI project in NICQ 8 was to decrease time to first skin to skin after admission.
It is standard work already in our NICU.
It ‘s part of Family Integrated Care work.
It’s part of a broader focus for all families delivering in our Family Birth Center

This is part of our NICU culture—we are believers in skin to skin.
Skin to skin is an important part of care and not just something nice to do (an “add on”).

And finally ….
We involved organizational leadership (Nursing Director, CNO).
Our Parent Action Committee members were on our team.
We have wonderful parents/ families in our NICU.
The Oregon effect.

Here are some photos of the great folks at Salem doing what they do best … working together and making magic happen for babies and families. 

So, do you want to beat Salem next year?  They have kindly told us all exactly what we need to do if we want to take their crown. 

Set a goal. We suggest at least 3 hours/baby/day.
Market it.
Help everyone understand the evidence–why skin to skin holding is an essential part of care.
Make skin to skin holding an expectation. Discuss at rounds and with families frequently.
Don’t forget dads.
Build documentation of S2S time into bedside work flow.
Continue to measure and share the results throughout the year.

Salem, we salute you!  Not just your tremendous focus on reuniting babies with their families, but also the generosity of spirit shown by how you share the secrets of your success.  You are true champions, each and every one of you. 

Check back next week for some more stories of success from some of the 38 hospitals involved in this amazing project. Until then, happy holding!

About the author


Kate Robson