Systems Integration: The Next Frontier in Newborn-Screening Timeliness

Area of Science:

• Public Health Laboratory Science
• Healthcare Systems Analysis
• Newborn Health

Background:

• Federal recommendations in 2015 aimed to improve newborn screening (NBS) timeliness, covering specimen collection, transport, testing, and reporting.
• Most state NBS programs have not met these recommended timeliness benchmarks.
• NBS timeliness is critical for early detection and intervention of heritable disorders in newborns.

Purpose of the Study:

• To explore processes and procedures that impact NBS timeliness from a public health laboratory perspective.
• To identify factors that accelerate or hinder improvements in NBS timeliness.
• To understand stakeholder strategies for enhancing NBS timeliness outcomes.

Main Methods:

• Conducted semistructured interviews with 21 public health laboratory personnel (directors, NBS program managers, follow-up staff).
• Performed content analysis of practices, processes, and procedures related to NBS timeliness.
• Conducted secondary analysis of interorganizational strategies for timeliness improvement.

Main Results:

• Laboratories implemented strategies such as engaging birthing providers, expanding courier services, extending operating hours, and modifying staffing.
• Cross-training schedules were used to facilitate prompt specimen collection, transport, and processing.
• Participants desired refined timeliness metric definitions for better cross-state comparisons.

Conclusions:

• Recent years have seen accelerated efforts to improve NBS timeliness.
• Sustained progress necessitates enhanced coordination and integration among all NBS delivery system stakeholders.
• Improved communication and integrated processes are vital for achieving and maintaining NBS timeliness benchmarks.