Building Bridges Between Parents and Neonatal Care Professionals: An Interview with Sari Ahlqvist-Björkroth

The Close Collaboration with Parents training program has been transforming neonatal care across multiple countries. As the program prepares for its first international conference in Lithuania, we spoke with Sari Ahlqvist-Björkroth, one of the program's creators, about its origins, evolution, and future.

What inspired the creation of the Close Collaboration with Parents program?

"Three things inspired the creation of the program," Sari explains. "First was my professional commitment to infant mental health. I started researching this field in the 90's for my master's thesis, which helped me understand the power of early parent-infant relationships. Second was my personal experience—the birth of my third son as a preemie. And third was meeting Professor Zack Boukydis and Liisa Lehtonen, who shared the same passion to improve infant and parent care in the NICU context."

Could you explain the core principles of the program and how it has evolved since its inception at Turku University Hospital?

"The Close Collaboration with Parents is a systematic educational program that transforms how neonatal professionals communicate with parents and support the parent-infant relationship," Sari explains. "What makes our approach unique is that we train entire units rather than individual staff members.”

The program unfolds through four evidence-based phases:

" First, staff develop skills in infant observation, learning to recognize each baby's unique preferences and needs, and communicating their observations with colleagues. Second, we introduce joint staff-parent observations to create collaborative care plans. Staff learn active listening techniques that help them value parents' insights about their babies. Third, staff learn to conduct semi-structured CLIP-I discussion that explore parents' journeys to parenthood. This fosters empathy and enables truly personalized support for each parent-infant relationship. Finally, we integrate parents into all aspects of decision-making—from daily care to medical rounds and discharge planning. We begin preparing for the transition home early, tailoring the process to each family's specific situation."

Sari emphasizes the program's practical approach: "While we provide theoretical content through e-learning and lectures, the heart of our method is experiential learning. Staff practice their new skills at the bedside with real families under the guidance of local mentors who have completed the training themselves. These mentors, alongside unit leadership, drive the implementation process."

Since its development at Turku University Hospital (2009-2012), the program has evolved significantly:

"The program has undergone several key refinements," Sari explains. " Supervision has been streamlined to focus on mentors and leadership rather than the entire staff, making better use of resources. The shared decision-making component has been strengthened through the incorporation of medical round observations. Documentation requirements have been added to ensure program fidelity, along with systems for continuous support to local mentors and leaders. For international implementation, an e-learning platform now standardizes theoretical content across different settings. Perhaps most exciting is our newest development—establishing our first designated training center, enabling one unit to train others within their country. This represents a significant step toward sustainable growth and wider adoption of family-centered care practices."

What motivated you to organize this first international conference in Lithuania?

"Before COVID-19, we organized annual national seminars for units that had implemented the program or were interested in it," Sari recalls. "When thinking about restarting these gatherings, we realized that since the intervention has expanded internationally, our 'seminar' should be international as well.

Our Finnish Rotary partners also encouraged us by offering financial support. Rotary International has supported the training of two NICUs—one in Riga, Latvia, and one in Pardubice, Czech Republic. They recognized that our program shares their values and wanted to continue their support by sponsoring this conference, which is why it's free of charge."

How many countries have participated in the program, and is it adaptable to different healthcare systems and cultural contexts?

"To date, units from 10 countries have implemented the program," Sari states proudly. "It has been implemented in 25 NICUs and six labor and delivery units. Its successful implementation in diverse cultural contexts, from South Korea to Norway, demonstrates its adaptability.

What makes the program so flexible is its structure. We provide the bedside practice and reflection framework that helps unit staff become aware of their family-centered practices and encourages them to innovate better approaches. A key aspect of our philosophy is that we don't impose standardized solutions from the outside. Instead, the program creates a framework where staff can discover what works best in their specific environment.

"One of our core principles," Sari emphasizes, "is that the program does not dictate change on the unit. The practice changes are decided by the staff themselves, based on the feedback they receive from parents during bedside practices. This bottom-up approach ensures new practices are directly adapted to each unit's unique context and cultural setting, making them more likely to be embraced and sustained over time."

At the conference, we'll have presentations from many different cultural settings, including Japan, South Korea, Israel, Czech Republic, Norway, Finland, and the Baltic countries."

What specific challenges do neonatal units face when implementing family-centered care practices, and how will the conference address them?

"Resources are probably the biggest challenge for most units," Sari acknowledges. "The implementation is based on the whole multiprofessional staff receiving training or, more accurately, mentoring from local mentors. This mentoring, which is mostly one-on-one, requires additional resources. At the conference, you'll hear about different implementation solutions.

Sustainability of change is also a common concern. This will be one of the main topics at the conference. Units that have been implementing for some time will report on how they've sustained desired changes and continued to develop."

How did the partnership between Finnish, Lithuanian, and other Baltic institutions develop for this conference?

"I hope this event will strengthen cooperation and support among countries in the field of family-centered neonatal care," Sari says. "The idea for the second day of the conference is to share good family-centered practices and learn from each other."

Is the conference exclusively for units who have undergone the Close Collaboration with Parents training, or would it be valuable for all professionals interested in family-centered care?

"The conference is open to all professionals interested in family-centered care," Sari emphasizes. "Our program is only one way to implement family-centered care; there are many others. Anyone can gain new perspectives and ideas from the conference without participating in our specific program. Of course, if someone wants to know more about Close Collaboration with Parents, this is a perfect event for them."