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Aligning Newborn Hyperbilirubinemia Care With American Academy of Pediatrics Guidelines at an Urban Community
Cris G Ebby1, Ann H Allen2, Kristin A Shadman2
1Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, cebby@uwhealth.org.
Insights
Newborn hyperbilirubinemia treatment was improved, significantly reducing inpatient phototherapy. This quality improvement initiative focused on guideline adherence, leading to fewer newborns requiring phototherapy during birth hospitalization.
Area of Science:
- Neonatal Medicine
- Pediatrics
- Quality Improvement
Background:
- The American Academy of Pediatrics updated its newborn hyperbilirubinemia guideline in August 2022.
- A quality improvement initiative was launched to decrease inpatient and subthreshold phototherapy for newborns.
Purpose of the Study:
- To reduce the number of newborns receiving inpatient phototherapy by 50% within 12 months.
- To decrease subthreshold phototherapy initiation in newborns.
Main Methods:
- A multidisciplinary team implemented interventions at an urban community hospital.
- Retrospective chart review analyzed data from February 2022 to November 2023.
- Outcomes included phototherapy use, readmissions, length of stay, and escalation of care criteria.
Main Results:
- Median monthly inpatient phototherapy decreased from 10 to 2 newborns.
- No significant change was observed in newborn readmissions.
- Length of stay and meeting escalation of care criteria remained unchanged.
Conclusions:
- The study demonstrated a significant reduction in inpatient phototherapy use for newborns during birth hospitalizations.
- The quality improvement initiative successfully decreased phototherapy initiation, aligning with updated guidelines.
Background:
In August 2022, the American Academy of Pediatrics updated its newborn hyperbilirubinemia guideline. This quality improvement initiative aimed to reduce newborns receiving inpatient phototherapy and subthreshold phototherapy initiation by 50% in 12 months.
Methods:
A multidisciplinary team implemented interventions at an urban community hospital in Wisconsin. Retrospective chart review from February 2022 through November 2023 identified newborns receiving phototherapy during birth hospitalization and readmission (primary outcome), subthreshold phototherapy initiation (process measure), and length of stay with meeting escalation of care criteria (balancing measures).
Results:
We identified 167 newborns. Median birth hospitalization phototherapy decreased from 10 to 2 newborns per month; there was no change in readmissions. Length of stay and meeting escalation of care criteria were unchanged.
Discussion:
This study shows a decrease in inpatient phototherapy use during birth hospitalizations.
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