NEO-SAFE: a clinical model for patients and healthcare personnel safety in primary level hospitals.

The article focuses on evaluating the effectiveness of NEO-SAFE (NEOnatal SAFety and training Elba), a care-network organizational model between a hub hospital (University Hospital of Pisa) and a spoke hospital (Portoferraio Hospital on Elba Island) aimed at improving neonatal safety and staff well-being in low-birth-volume centers. Implemented from 2017, the project combined continuous theoretical and practical training, on-site and remote tutoring via telemedicine, and the drafting of common clinical protocols. Results showed a decreasing trend in neonatal transfers to the hub’s neonatal intensive care unit, improved self-confidence and reduced anxiety among healthcare personnel, and enhanced patient safety without adverse outcomes. The study highlights telemedicine as a valuable tool for remote support and suggests that such a model is a safe, cost-effective, and reproducible approach for geographically isolated or low-volume birth centers where closure is not feasible.