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Neonatal Jaundice: Improved Quality and Cost Savings After Implementation of a Standard Pathway

Holly M Romero1,2,3, Coral Ringer3, Michael G Leu2,3,4

  • 1Hawaii Permanente Medical Group, Honolulu, Hawaii; holly.m.romero@kp.org.

Pediatrics
|February 23, 2018
PubMed

Insights

Implementing a standard care pathway for neonatal jaundice significantly reduced hospital length of stay and costs. This evidence-based approach improved efficiency and decreased invasive treatments for newborns.

Area of Science:

  • Neonatal care
  • Healthcare management
  • Evidence-based practice

Background:

  • Neonatal jaundice is a common condition requiring effective management.
  • Optimizing care pathways can improve patient outcomes and reduce healthcare costs.

Purpose of the Study:

  • To develop and implement an evidence-based standard care pathway for neonatal jaundice.
  • To evaluate the impact of the pathway on quality metrics and cost-effectiveness.

Main Methods:

  • Assembled a multidisciplinary team to create a treatment algorithm and computer order sets.
  • Implemented the pathway and compared quality metrics (length of stay, phototherapy initiation time) before and after.
  • Analyzed cost impacts using external data.

Main Results:

  • Mean length of stay decreased from 1.30 to 0.87 days (P < .001).
  • Mean time to phototherapy initiation reduced to 54.67 minutes (P = .03).
  • Intravenous fluid orders decreased from 80% to 44% (P < .001), with significant cost reductions.

Conclusions:

  • An evidence-based standard care pathway for neonatal jaundice improves multiple value dimensions.
  • The pathway led to significant reductions in length of stay, healthcare costs, and invasive interventions.
Abstract

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