Neonatal hyperbilirubinemia management: a model for change.
Currently, active public health surveillance of hyperbilirubinemia and kernicterus is lacking. Recently, the Hospital Corporation of America (HCA), a private health care system with an estimated quarter of a million births annually, instituted recommendations to provide universal hyperbilirubinemia screening before discharge for all infants born within their system. Over 98% of the infants born at HCA hospitals were screened within the first year of the recommendations. From May to December 2004, 13 infants were identified with total serum bilirubin (TSB) >/=30 mg per 100 ml, but that number was reduced in 2006, with only seven infants born in HCA hospitals developing a TSB of >/=30 mg per 100 ml. This program provides a model for actively monitoring the occurrence of hyperbilirubinemia and for tracking its occurrence, thus improving health care quality for patients while collecting important public health information.
Lazarus
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National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA. clazarus@gmail.com
Avchen
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D006777:Hospitals, Proprietary; D006801:Humans; D007231:Infant, Newborn; D007567:Jaundice, Neonatal / Q000175:diagnosis* / Q000628:therapy*; D007647:Kernicterus / Q000175:diagnosis / Q000517:prevention & control*; D009096:Multi-Institutional Systems / Q000592:standards*; D015997:Neonatal Screening / Q000592:standards*; D010043:Outcome and Process Assessment, Health Care; D010347:Patient Care Planning / Q000592:standards*