In partnership with the Oklahoma Hospital Association and March of the Dimes, the Health Department launched a program called Every Baby Counts in early 2015 to improve the accuracy and timeliness of the state’s newborn screening process.
First, the program focused on training healthcare providers to properly collect samples from newborns. In February 2016, the program received additional funding through a grant to implement additional timeliness training.
Hospitals with birthing centers improved with the 48-hour requirement over the past two-and-a-half years, increasing the compliance rate from 67 percent in 2015 to 82 percent in 2016.
For the first quarter of 2017, 82 percent of all newborn blood samples were sent for testing within a 48-hour period, the Health Department data shows.
“I think I would like to add that we’ve had a lot of hospital participation across the state, tuning in and asking questions, and they’ve made improvements and strides,” Caton said. “Kudos to them.”
Tonya McCallister, a training lab supervisor for the Health Department, said reports are provided to hospitals so they can see how many of their samples are meeting the 48-hour mark. Then, the agency can provide feedback and better resources, she said.
Another challenge facing some hospitals is the courier service that delivers tests to the lab in Oklahoma City.
The number of hospitals that have seven-day delivery has grown over the past two-and-a-half years with the Every Baby Counts program, said LaWanna Halstead, vice president of Quality and Clinical Initiatives for the Oklahoma Hospital Association.
Still, some couriers have to drive four hours to deliver the tests to the state lab, Halstead said.
Though most hospitals have seven-day service, at least 12 can send their samples only on weekdays.
“The Health Department pays for a courier to go to almost every birthing department in the state every day. There are a handful of low-volume hospitals that go five days a week, rather than seven days.”
“That’s huge that the courier comes seven days a week.”
Halstead said the association aims to continue improvements on the courier system to fix minor hitches and is considering educating the couriers on newborn screening.
Another hurdle to timely screening is accuracy.
When a healthcare provider collects a newborn’s blood for testing, the droplets must fall perfectly into the circles on the screening card, Halstead said.
“It might sound really simple to stick a baby’s heel and put some blood on a piece of paper, but it’s very complex,” Halstead said.
Sometimes getting blood out of a newborn’s heel is challenging, and health care providers have to wait at least 24 hours after birth before they can collect the sample, she said.
“There are so many phases in the process where it can break down,” Halstead said.
To increase the precision of newborn screening, a team from the Health Department began visiting hospitals in late 2016 and had health care providers walk them through their screening process in order to identify snags that could make it difficult to get the samples to the department within 48 hours, Halstead said.
“We’ll keep monitoring the results for timeliness and accuracy and send those results to the hospital,” she said.
And more tests have been added to the screening panel, including hearing screens and clinical congenital heart disease tests, Halstead said.
“It’s a continually growing area,” Halstead said. “It’s not perfect, but we’ve moved (up).”