Improving the Bilirubin Management Program in the Newborn Nursery: Background, Aims, and Protocol

Area of Science:

• Neonatal care
• Pediatric quality improvement
• Bilirubin metabolism

Background:

• Current practices for detecting and managing newborn hyperbilirubinemia (jaundice) are inconsistent.
• Published guidelines have led to varied approaches, potentially impacting care quality and cost.
• There is a need for evidence-based, standardized methods to reduce emergency room visits and hospital readmissions for jaundice.

Purpose of the Study:

• To implement and evaluate a prospective quality improvement program for newborn hyperbilirubinemia management.
• To assess the value of specific changes in diagnosis, safety, outcomes, and cost related to jaundice care.
• To gather data for developing new evidence-based strategies for neonatal jaundice.

Main Methods:

• Utilizing existing data from approximately 400,000 well infants within the Intermountain Healthcare system.
• Conducting a pre- versus post-practice change analysis to assess specific outcomes.
• Implementing changes in the University of Utah Newborn Nursery during 2020.

Main Results:

• The study aims to identify perceived problems in current bilirubin management systems through stakeholder input.
• Analysis will focus on the feasibility and effectiveness of proposed changes.
• Data will inform the development of improved jaundice management protocols.

Conclusions:

• The quality improvement project is expected to yield insights into optimizing newborn hyperbilirubinemia care.
• Findings will contribute to establishing uniform, safe, and cost-effective strategies for managing neonatal jaundice.
• The ultimate goal is to reduce emergency interventions and hospital readmissions associated with jaundice and prevent bilirubin encephalopathy.