Every Baby Counts QI Program
The “Every Baby Counts” Quality Improvement (QI) Program is designed to improve the processes for timely collection and submission of quality newborn screening (NBS) specimens for testing at the OSDH Public Health Laboratory (PHL). Delayed testing, due to improper specimen collection or prolonged transit time, deters early detection and intervention for critical conditions that could lead to permanent damage or death of a child within the first few days of life. Transit times and unsatisfactory specimen submission rates are tracked for each specimen submitted for newborn screen testing. See the link below for summary data for each birthing facility in Oklahoma.
Under 63 O.S., Sections 1-533 and 1-534, specific Rules and Regulations have been established for newborn screening and follow-up of all infants born in Oklahoma. NBS dried blood spot specimens must:
- Be collected as early as possible AFTER 24 hours of age or immediately prior to discharge, whichever comes first; if for any reason a specimen is collected prior to 24 hours of age, the hospital and physician are responsible for ensuring that a repeat specimen is collected between 3 and 5 days of age and submitted for testing;
- Be sent to the OSDH PHL within 24 hours after collection;
- Arrive at the OSDH PHL no later than 48 hours after collection.
Submitters are also responsible for submitting specimens of adequate quality for testing. Improperly collected or processed specimens may prove unsatisfactory for testing, resulting in the need to collect a new specimen and delaying results. Accordingly, specimen quality improvement goals are a component of the “Every Baby Counts” QI Program, aimed at reducing the number of submitted unsatisfactory specimens.
To ensure successful collection/processing/submission of specimens, we recommend that birthing facilities:
- Ensure that all personnel involved in collection/processing/submission of NBS bloodspots receive adequate training;
- If feasible, have an individual who is well-trained in bloodspot collection double-check the quality of the specimen before it is sent for testing;
- Check the expiration date of the filter paper prior to collection;
- Air-dry specimens horizontally for 3-4 hours after collection;
- Send specimens immediately for testing once dry, and do not batch specimens;
- Maintain a newborn screening log which includes: name, date of birth, attending physician, planned health care provider, medical record number, serial number of NBS Kit, date of collection, date of submission, date test results were received, and screening results.
Step-by-step instructions for completing the NBS specimen collection form, and a list of NBS Provider ID#’s can be found in the following links.
Efficient specimen collection and handling processes within birthing facilities are only one component for ensuring prompt testing of NBS specimens. The “Every Baby Counts” QI Program is actively exploring ways to improve efficiencies in courier pick-up and transportation of specimens to the OSDH PHL, and in receipt, processing and testing of specimens within the OSDH PHL. The following link displays a map of the current courier services provided by the OSDH PHL.