Lab Matters Fall 2019 - Page 34

NEWBORN SCREENING Using Continuous Quality Improvement to Improve Newborn Screening Systems By Chenelle Norman, MPH, manager, Newborn Screening Quality Improvement Continuous quality improvement (CQI) is an organizational philosophy rooted in the automotive and manufacturing industry that, beginning in the early nineties, expanded into the fields of healthcare and public health. Today CQI is credited with promoting innovations in healthcare delivery by introducing system changes that have led to improvements such as the reduction in hospital-acquired infections, reduction in mother-to-child HIV transmission and advances in patient safety. These outcomes have cemented CQI as an important component to healthcare and public health systems including newborn screening. Using CQI to improve organizational outcomes and objectives is critical in newborn screening (NBS) systems where ensuring that every baby is screened appropriately and efficiently can be a matter of life or death. With funding support from the Health Resources and Services Administration (HRSA), APHL is making CQI a priority for newborn screening programs aiming to address longstanding challenges and system-wide inefficiencies. Championing a Culture of NBS CQI The NewSTEPs Quality Improvement Project is a five-year collaborative that provides funding support to NBS state and territorial programs while also developing leaders who can champion a culture of CQI among their NBS colleagues and create a space to share best practices and lessons learned using data and storytelling. Like the moonshot factory at Google, which brings entrepreneurs together to identify radical solutions to some of the world’s largest problems, applicants for the NewSTEPs Quality Improvement Project are encouraged to identify innovative solutions and approaches to improving NBS using CQI. Recent awardees of the NewSTEPs Quality Improvement Project identified unique and innovative solutions in NBS-specific areas including education, timeliness and health information technology. For example Colorado’s NBS program plans to use the data visualization tool Tableau to develop dashboards that will track data entry in real-time in order to monitor and improve performance of data submission. Another awardee, New York State, has proposed the creation of an electronic hospital communications portal or app that will enable its NBS program to communicate information directly to area hospitals. Although the NewSTEPs Quality Improvement Project is in its infancy, there is much excitement about its potential impact over the next five years. The opportunity to allow for continuous testing of new ideas and solutions and to implement those that work could transform how many NBS systems screen babies and save lives. n Next Steps Toward Newborn Screening Data Exchange by Mary Kate Yost-Daljev, PhD, J Michael Consulting; Marci Sontag, PhD, Center for Public Health Innovation and Joshua Miller, MPH, Center for Public Health Innovation Timely and accurate communication among all partners is paramount to achieving positive outcomes in newborn screening (NBS). Electronic data exchange is the bedrock of this communication, yet the implementation of seamless data interoperability for NBS has been variable among jurisdictions. Data exchange, as it applies to NBS, encompasses orders and results exchanged between the health care provider and the screening laboratory, and extends to other key clinical and public health partners. In May 2019, J Michael Consulting (JMC) and NewSTEPs 360 at the Center for Public Health Innovation (CPHI) convened a meeting in Atlanta to better understand the current state of NBS data interoperability and develop recommendations to address the barriers to national adoption 32 LAB MATTERS Fall 2019 of electronic data exchange for NBS. Barriers identified include lack of resources and stakeholder engagement. Attendees from state public health departments and laboratories, the US Centers for Disease Control and Prevention (CDC) and the Association of Public Health Laboratories (APHL) developed recommendations and a roadmap to improve NBS data interoperability, including strategies to expand the adoption of electronic data exchange. In follow up to the meeting, JMC and CPHI authored a report that illustrates dependencies among NBS stakeholders and outlines recommendations to drive NBS data exchange toward these goals. The first recommendation is to form a steering committee to direct activities to promote interoperability, provide technical assistance, bolster partnerships and serve as a common voice for all NBS stakeholders. At the direction of the steering committee, the goals of the NBS community will include: • harmonization of electronic messaging • development of resources to assist stakeholders in implementation efforts • fostering collaboration among public, private and government partners. The group also envisioned an ideal NBS data exchange with a platform to streamline transmission and translation of NBS data among partners. These recommendations outline efforts the NBS community can undertake to address the above barriers and move data interoperability forward. n PublicHealthLabs @APHL APHL.org