Quality Indicators

Quality Indicator 3: Percent of eligible newborns not receiving a newborn screen, reported by dried blood spot or point of care screen(s)

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Purpose:  To determine the proportion of eligible newborns1 that were not screened due to parental refusal, pre-analytic error, and missing or unmatched screens for dried blood spot and point-of-care screens.

a) Percent of eligible1 newborns without a:

  • i. Valid dried blood spot nebworn screen
  • ii. Document critical congenital heart disease (CCHD) screen
  • iii. Document early hearing detection and intervention (EHDI) screen

b) Percent of eligible newborns1 without the following screens due to parent refusal:2

  • i. Valid dried blood spot nebworn screen
  • ii. Document critical congenital heart disease (CCHD) screen
  • iii. Document early hearing detection and intervention (EHDI) screen

c) Percent of eligible newborns1 without the following screens due to pre-analytic error:3

  • i. Valid dried blood spot nebworn screen
  • ii. Document critical congenital heart disease (CCHD) screen
  • iii. Document early hearing detection and intervention (EHDI) screen

d) In two screen states, percent of eligible newborns1 without a valid first and second dried blood spot screen due to a missing or unmatched second screen.

e) Within states that link newborn screening results to the electronic birth certificate/ vital records, the precent of eligible newborns1 that have been matched to screenign specimens/ results:4

  • i. Valid dried blood spot nebworn screen
  • i. Document critical congenital heart disease (CCHD) screen
  • iii. Document early hearing detection and intervention (EHDI) screen

Screening Data for Denominators: Number of newborns, born in your state, considered eligible for newborn screening.1

Footnotes:

  1. Eligibility for newborn screening is defined in Appendix A: Glossary of Terms of the QI Source Document.
  2. The number of refusals includes only those known by the state program. In the NewSTEPs Repository, state profiles will measure how state newborn screening programs collect information on refusals for both dried blood spot newborn screening and point-of-care tests.This includes any pre-analytic event, except for parent refusal, that would prevent the newborn from receiving a complete screen. For dried blood spot screens, some examples include: unacceptable specimens that never had a subsequent speciment requested, collected, or received at the laboratory, specimens lost in transit, or specimens for which hospital personnel forgot to either collect or ship the specimen. For point-of-care screens, some examples include: malfunctioning screening equipment, child discharged prior to screen, or misinterpretation of the point-of-care algorithm.Each state's capacity to link newborn screening dried blood spot information to vital statistics and electronic birth records will be captured in the NewSTEPs Repository under state profiles and data reported will reflect the state's policy for linking specimens.