Neonatal Discharge Planning: Could Unscheduled Reviews be reduced in the First Six Weeks of Life?

The postnatal period offers an opportunity to provide information and education to new mothers. We analysed factors associated with unscheduled presentations of newborns to local primary care, maternity and paediatric services over a 3 week period to assess whether these could be targeted with discharge planning educational interventions. Data was collected prospectively from electronic databases and manually from patient records in the maternity hospital. Two hundred and seventy six patients under 6 weeks of age presented to the three services. Half of these visits were unscheduled 137 (49%). 40 (29%) of those that were unscheduled were felt to represent benign neonatal variants whilst 28 (20%) presented with feeding problems. Eighty one (59.3%) patients were discharged home, and this was unaffected by referrer patterns; GPs 19 (56%), Nurses 13 (57%) or parents77 (67%). At least 40 (29%) of reviews were felt to be inappropriate and could have been prevented. There is room for cost saving and quality improvement of the service through education.