Timeliness Toolkit for Expanding Newborn Screening Services


The toolkit for expanding newborn screening services was developed by NewSTEPs 360, a collaboration between the Colorado School of Public Health (CoSPH) and the Association of Public Health Laboratories to support states to make improvements in their courier and newborn screening (NBS) laboratory operations. It is designed to assist state NBS programs, advocates, legal, and public health professionals to shape appropriate policies and communicate the value of weekend and holiday courier and laboratory operations in order to improve timeliness in newborn screening.

Each year, 12,000 babies with serious, but treatable conditions grow up healthy because of newborn screening (NBS). NBS is a vital public health program that identifies newborns at risk of developing critical disorders that may not show symptoms at birth but can cause permanent disability or death if not detected and treated in the first few days of life. It is a complex system that involves families, birthing facilities, laboratories, follow-up programs and healthcare providers. Any delay in the newborn screening process may jeopardize the health and survival of affected babies.

In November 2013, the article Deadly Delays in the Milwaukee Journal Sentinel found evidence of serious delays in newborn screening programs across the country due to laboratory closures on weekends and holidays, limited use of courier services to transport samples from hospitals to the NBS lab, and little to no consequences for hospitals that sent late samples.

Over the past 2-4 years, many states have implemented a number of changes in newborn screening practices in order to improve health outcomes for newborns. The most significant of these changes include solutions to address courier transit times and the expansion of NBS laboratory operating hours. In particular, allowing labs to remain open six to seven days per week, greatly increases the lab’s ability to receive and process specimens on the weekends. It has been demonstrated that states who have expanded newborn screening lab hours are more likely to achieve the 95% timeliness reporting goal. For more information, see the 2016 NewSTEPs Timeliness Report submitted to the United States Government Accountability Office. 

The material contained in this toolkit is designed to be customized based on the needs of the individual state or newborn screening program. 


Section 1

Making the Case for Change: A Tip Sheet for NBS Programs

Section 2

Policy Guide

Section 3

Law and Regulations Decision Tree

Section 4

"Cookbook" Policy Guide for NBS Staff

Section 5

Communication Materials

Section 6

Overview of NBS Weekend & Holiday Operations

Section 7

Steps and Considerations for Newborn Screening Staff

Section 8

Newborn Screening Timeliness Simulator