Aim: To explore parents' perspectives regarding participation in neonatal care, with focus on the family integrated care (FICare) model utilised as a tool to enhance parent–infant closeness. Additionally, we describe experiences in different architectural settings.Methods: An online survey, categorised by four FICare pillars, was distributed through social media to parents of newborns hospitalised to Dutch neonatal wards between 2015 and 2020. Quantitative findings were summarised using descriptive statistics, while open‐ended responses were thematically analysed.Results: Among the 344 respondents (98% mothers), most reported feeling involved in care (315/340). However, 79% also felt separated from their infant (265/337). Irrespective of architectural settings, parents reported incomplete implementation of FICare pillars: 14% was invited to educational sessions (parent education), 51% discussed family‐specific care plans (staff education), 21% was facilitated in connecting with veteran parents (psychosocial support) and 22% received couplet‐care (environment). Although 65% of parents were invited to attend clinical rounds, 32% actively participated in decision making. Thematic analysis revealed fundamentals for feeling welcome on the ward, peer‐to‐peer support, psychosocial support and participation in clinical rounds.Conclusion: Overall, parents expressed satisfaction with participation in neonatal care. However, structural implementation of FICare lacks. Regardless of architecture, expanding parent participation beyond presence requires attention.

Parents are often appointed a passive role in the care for their hospitalised child. In the family-integrated care (FICare) model, parental involvement in neonatal care is emulated. Parental participation in medical rounds, or family-centred rounds (FCR), forms a key element. A paucity remains of randomised trials assessing the outcomes of FCR (embedded in FICare) in families and neonates, and outcomes on an organisational level are relatively unexplored. Likewise, biological mechanisms through which a potential effect may be exerted are lacking robust evidence. Ten level two Dutch neonatal wards are involved in this stepped-wedge cluster-randomised trial FCR (embedded in FICare) by one common implementation strategy. Parents of infants hospitalised for at least 7 days are eligible for inclusion. The primary outcome is parental stress (PSS:NICU) at discharge. Secondary outcomes include parental, neonatal, healthcare professional and organisational outcomes. Biomarkers of stress will be analysed in parent–infant dyads. With a practical approach and broad outcome set, this study aims to obtain evidence on the possible (mechanistic) effect of FCR (as part of FICare) on parents, infants, healthcare professionals and organisations. The practical approach provides (experiences of) FICare material adjusted to the Dutch setting, available for other hospitals after the study.

Background: Family Integrated Care (FICare), including Family-Centered Rounds (FCR), aims to actively involve parents in neonatal care. We hypothesised that FCR as part of FICare would reduce hospital stay and improve neonatal outcomes in level II neonatal wards.Methods: This multicentre, stepped-wedge cluster-randomised trial was conducted in ten level II neonatal wards in the Netherlands (March 2022–December 2023). During the study, all participating wards transitioned from providing standard neonatal care (SNC) to FICare including FCR. Here we report the neonatal outcomes regarding length of hospital stay, growth, feeding regimen, respiratory support and sepsis treatment. Linear mixed-effects models were used, with hospital and family included as random intercepts, and intervention status and time as fixed effects to account for the stepped-wedge design.Findings: A total of 518 families with 599 infants hospitalized ≥7 days were included. Infants in FICare had a significantly shorter hospital stay compared to SNC (19 days [IQR 13–34] versus 21 days [IQR 13–30], adjusted mean ratio: 0·93 [0·87–0·99]; P = ·02). Exclusive breastfeeding at discharge was more common in FICare (37%) than in SNC (24%) (adjusted odds ratio: 1·86 [1·25–2·79]; P = ·00). Parenteral nutrition use was lower in FICare (31%) versus SNC (35%) (adjusted odds ratio: 0·64 [0·43–0·95]; P = ·03). No significant differences were found in weight gain, tube feeding, respiratory support, or sepsis treatment. A prehoc analysis among infants transferred from other hospitals showed similar benefits.Interpretation: Implementation of FICare, including FCR, in level II neonatal wards reduced length of hospital stay, increased exclusive breastfeeding at discharge, and reduced the need for parenteral nutrition.