title: Improving newborn screening follow-up in pediatric practices: quality improvement innovation network.
abstract: OBJECTIVE
  To implement a 6-month quality improvement project in 15 primary care pediatric practices to improve short-term newborn screening (NBS) follow-up.
  
  
  METHODS
  At the start of the project, each practice completed a survey to evaluate office systems related to NBS and completed a chart audit. Practice teams were provided information about NBS and trained in quality-improvement methods, and then implemented changes to improve care. Monthly chart audits over a 6-month period were completed to assess change.
  
  
  RESULTS
  At baseline, almost half of practices completed assessment of infants for NBS; after 6 months, 80% of practices completed assessment of all infants. Only 2 practices documented all in-range results and shared them with parents at baseline; by completion, 10 of 15 practices documented and shared in-range results for ≥ 70% of infants. Use of the American College of Medical Genetics ACTion sheets, a decision support tool, increased from 1 of 15 practices at baseline to 7 of 15 at completion.
  
  
  CONCLUSIONS
  Practices were successful in improving NBS processes, including assessment, documentation, and communication with families. Providers perceived no increase in provider time at first visit, 2- to 4-week visit, or during first contact with the family of an infant with an out-of-range result after implementation of improved processes. Primary care practices increased their use of decision support tools after the project.
authors.affiliation: National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Cynthia F
authors.initials: CF
authors.lastname: Hinton
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Neuspiel
authors.forename: Ruth S
authors.initials: RS
authors.lastname: Gubernick
authors.forename: Timothy
authors.initials: T
authors.lastname: Geleske
authors.forename: Jill
authors.initials: J
authors.lastname: Healy
authors.forename: Alex R
authors.initials: AR
authors.lastname: Kemper
authors.forename: Michele A
authors.initials: MA
authors.lastname: Lloyd-Puryear
authors.forename: Robert A
authors.initials: RA
authors.lastname: Saul
authors.forename: Barry H
authors.initials: BH
authors.lastname: Thompson
authors.forename: Celia I
authors.initials: CI
authors.lastname: Kaye
mesh_terms: D003266:Continuity of Patient Care; D006801:Humans; D007231:Infant, Newborn; D008499:Medical Records; D015997:Neonatal Screening; D010372:Pediatrics; D011320:Primary Health Care; D058996:Quality Improvement; D011787:Quality of Health Care