title: Influence of changes in the evaluation of neonatal jaundice.
abstract: OBJECTIVE
  To study the influence of policy changes in the evaluation of neonatal hyperbilirubinemia on discharge process from the nursery. Changes included early assessment of risk factors by universal umbilical blood sampling for blood type, Coombs test, and glucose-6-phosphate dehydrogenase (G6PD) and universal noninvasive transcutaneous bilirubinometry at discharge.
  
  
  METHODS
  The 1,569 newborns (≥ 36 weeks' gestation) admitted after the implementation of changes were compared with the 1,822 born before.
  
  
  RESULTS
  Policy changes improved the diagnosis of G6PD deficiency and ABO incompatibility and decreased the number of referrals from the community for jaundice follow-up. The average number of needlesticks per baby as well as the time required for the analysis of serum bilirubin levels on discharge day decreased. Changes did not significantly increase costs.
  
  
  CONCLUSIONS
  Changes seem to have improved the quality of medical care, including early identification of risk factors and better follow-up of neonatal hyperbilirubinemia with reduction of pain and increased efficiency.
authors.affiliation: Department of Neonatology, Bnai Zion Medical Center, Rappaort Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.
authors.forename: Arieh
authors.initials: A
authors.lastname: Riskin
authors.affiliation: Department of Neonatology, Bnai Zion Medical Center, Rappaort Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.
authors.forename: Keren
authors.initials: K
authors.lastname: Cohen
authors.affiliation: Department of Neonatology, Bnai Zion Medical Center, Rappaort Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.
authors.forename: Amir
authors.initials: A
authors.lastname: Kugelman
authors.affiliation: Department of Neonatology, Bnai Zion Medical Center, Rappaort Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.
authors.forename: Marta
authors.initials: M
authors.lastname: Abend-Weinger
authors.affiliation: Department of Neonatology, Bnai Zion Medical Center, Rappaort Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.
authors.forename: Miri
authors.initials: M
authors.lastname: Hemo
authors.affiliation: Department of Neonatology, Bnai Zion Medical Center, Rappaort Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.
authors.forename: David
authors.initials: D
authors.lastname: Bader
mesh_terms: D001663:Bilirubin / Q000097:blood; D003298:Coombs Test; D005312:Fetal Blood / Q000737:chemistry; D005955:Glucosephosphate Dehydrogenase Deficiency / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000175:diagnosis*; D007231:Infant, Newborn; D007557:Israel; D007567:Jaundice, Neonatal / Q000209:etiology*; D015997:Neonatal Screening / Q000379:methods / Q000639:trends; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D001663:Bilirubin