Cochran Amy L, Tarini Beth A, Kleyn Mary, Zayas-Cabán Gabriel
Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, USA.
Department of Pediatrics, University of Iowa, Iowa City, USA.
Matern Child Health J. 2018 Oct;22(10):1436-1443. doi: 10.1007/s10995-018-2524-z.
Objectives This study aimed to determine which steps in the newborn screening collection and delivery processes contribute to delays and identify strategies to improve timeliness. Methods Data was analyzed from infants (N = 94,770) who underwent newborn screening at 83 hospitals in Michigan between April 2014 and March 2015. Linear mixed effects models estimated effects of hospital and newborn characteristics on times between steps in the process, whereas simulation explored how to improve timeliness through adjustments to schedules for the state laboratory and for specimen pickup from hospitals. Results Time from collection to receipt of arrival to the state laboratory varied greatly with collection timing (P < 0.001), with specimens collected on Friday or Saturday delayed an average of 9-12 h compared to other specimens. Simulation estimates shifting specimen pickup from 6 p.m. Sunday-Friday to 9 p.m. Sunday-Friday could lead to an additional 12.6% of specimens received by the Michigan laboratory within 60 h of birth. Conclusions for Practice The time between when a specimen is collected and received by the laboratory can be a significant bottleneck in the newborn screening process. Modifying hospital pickup schedules appears to be a simple way to improve timeliness.
目的 本研究旨在确定新生儿筛查采集和递送过程中的哪些步骤会导致延迟，并确定提高及时性的策略。方法 对2014年4月至2015年3月期间在密歇根州83家医院接受新生儿筛查的婴儿（N = 94,770）的数据进行了分析。线性混合效应模型估计了医院和新生儿特征对过程中各步骤之间时间的影响，而模拟则探讨了如何通过调整州实验室和从医院采集标本的时间表来提高及时性。结果 从采集到送达州实验室的时间因采集时间而异（P < 0.001），与其他标本相比，周五或周六采集的标本平均延迟9 - 12小时。模拟估计将标本采集时间从周日至周五下午6点改为周日至周五晚上9点，可使密歇根实验室在出生后60小时内收到的标本增加12.6%。实践结论 标本从采集到实验室接收之间的时间可能是新生儿筛查过程中的一个重大瓶颈。修改医院采集时间表似乎是提高及时性的一种简单方法。
