OPQI has partnered with the Oklahoma State Department of Health (OSDH) Newborn Screening Program’s Every Baby Counts Quality Improvement Program. Every Baby Counts is designed to improve the processes for timely collection and submission of newborn screening (NBS) specimens for testing at the OSDH Public Health Laboratory (PHL). Delayed testing, due to improper specimen collection or prolonged transit time, deters early detection and intervention for critical conditions that could lead to permanent damage or death of a child within the first few days of life.
To promote education among health care professionals who may be submitting specimens, OPQI has developed an on-line education module that includes information about the rules and regulations along with videos demonstrating the newborn screening collection process. The on-line training is developed with permission only for Oklahoma birthing hospitals. Managers and educators interested in utilizing the online education with their staff can request the password to the on-line education module from email@example.com. Other resources can also be found at https://opqic.org/newbornscreening.
Per Oklahoma law (OS 63 Sections 1-533 and 1-534), NBS dried blood spot specimens must:
- Be collected as early as possible AFTER 24 hours of age or immediately prior to discharge, whichever comes first; if for any reason a specimen is collected prior to 24 hours of age, the hospital and physician are responsible for ensuring that a repeat specimen is collected at between 3 and 5 days of age;
- Arrive at the OSDH PHL no later than 48 hours after collection.
Submitters are also responsible for submitting satisfactory specimens. Improperly collected specimens may prove unsatisfactory for testing, resulting in the need to collect a new specimen and delaying reporting of results. Accordingly, specimen quality improvement goals are a component of the “Every Baby Counts” QI Program, aimed at reducing the number of submitted unsatisfactory specimens.
Hospitals can find their Unsatisfactory Specimen and Transit Time reports at the OSDH Every Baby Counts website. Having a <5% rate of “Unsatisfactory” specimens is a criteria for a hospital to be eligible for a 2018 Spotlight Hospital award at the OPQIC Summit.
To ensure successful collection/processing/submission of specimens, it is recommended that birthing facilities:
- Ensure that all personnel involved in collection/processing/submission of NBS bloodspots receive adequate training;
- Check the expiration date of the filter paper prior to collection;
- Air-dry specimens horizontally for 3-4 hours after collection;
- Once dried, send specimens with the next courier pick up service, and do not batch specimens;
- Maintain a Specimen Collection Log documenting all required and recommended components; and
- If feasible, have an individual who is well-trained in bloodspot collection double-check the quality of the specimen before it is sent for testing.
OPQI plans to continue to support hospitals in reaching the Every Baby Counts QI Program goals. If you would like assistance at your hospital, please reach out to firstname.lastname@example.org.