Current Methods of Newborn Screening Follow-Up for Sickle Cell Disease Are Highly Variable and without Quality Assurance: Results from the ENHANCE Study
Newborn screening (NBS) for sickle cell disease (SCD) has significantly improved childhood survival but there are still gaps resulting in delayed care for affected infants. As a state-run program, there are no national quality assurance programs to ensure each state achieves consistent, reliable out...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-03-01
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| Series: | International Journal of Neonatal Screening |
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| Online Access: | https://www.mdpi.com/2409-515X/10/1/22 |
| _version_ | 1797240638482153472 |
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| author | Najibah Galadanci Shannon Phillips Alyssa Schlenz Nataliya Ivankova Julie Kanter |
| author_facet | Najibah Galadanci Shannon Phillips Alyssa Schlenz Nataliya Ivankova Julie Kanter |
| author_sort | Najibah Galadanci |
| collection | DOAJ |
| description | Newborn screening (NBS) for sickle cell disease (SCD) has significantly improved childhood survival but there are still gaps resulting in delayed care for affected infants. As a state-run program, there are no national quality assurance programs to ensure each state achieves consistent, reliable outcomes. We performed this qualitative study of NBS follow-up practices to better evaluate and understand the multi-level, state-specific processes of how each state’s public health department delivers the NBS results to families, how/if they ensure affected infants are seen quickly by sickle cell specialists, and to determine the close-out processes used in each state. This project used semi-structured interviews conducted with 29 participants across eight states to explore these NBS follow-up processes in each state. Participants included SCD providers, NBS coordinators, or personnel associated with state health departments and community-based SCD organizations (CBO). Our results show significant state-dependent variations in the NBS processes of information delivery and patient management. Specifically, programs differed in how they communicated results to affected families and which other organizations were informed of the diagnosis. There was also state-based (and intrastate) variation in who should assume responsibility for ensuring that infants receive confirmatory testing and are promptly started on penicillin prophylaxis. Case closure was also highly variable and poorly validated. Our results also yielded identifiable challenges and facilitators to NBS which were highly variable by state but potentially addressable in the future. This information suggests opportunities for systematic improvement in NBS follow-up processes. |
| first_indexed | 2024-04-24T18:10:37Z |
| format | Article |
| id | doaj.art-beeee6c2633748b8a28cca252c1d9aeb |
| institution | Directory Open Access Journal |
| issn | 2409-515X |
| language | English |
| last_indexed | 2024-04-24T18:10:37Z |
| publishDate | 2024-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | International Journal of Neonatal Screening |
| spelling | doaj.art-beeee6c2633748b8a28cca252c1d9aeb2024-03-27T13:46:34ZengMDPI AGInternational Journal of Neonatal Screening2409-515X2024-03-011012210.3390/ijns10010022Current Methods of Newborn Screening Follow-Up for Sickle Cell Disease Are Highly Variable and without Quality Assurance: Results from the ENHANCE StudyNajibah Galadanci0Shannon Phillips1Alyssa Schlenz2Nataliya Ivankova3Julie Kanter4Division of Hematology and Oncology, Department of Medicine, Heersink School of Medicine, The University of Alabama at Birmingham, Birmingham, AL 35233, USADepartment of Pediatrics, College of Nursing, Medical University of South Carolina, Charleston, SC 29425, USADepartment of Pediatrics, University of Colorado School of Medicine, Aurora, CO 80045, USASchool of Health Professionals, Health Services Administration, The University of Alabama at Birmingham, Birmingham, AL 35233, USADivision of Hematology and Oncology, Department of Medicine, Heersink School of Medicine, The University of Alabama at Birmingham, Birmingham, AL 35233, USANewborn screening (NBS) for sickle cell disease (SCD) has significantly improved childhood survival but there are still gaps resulting in delayed care for affected infants. As a state-run program, there are no national quality assurance programs to ensure each state achieves consistent, reliable outcomes. We performed this qualitative study of NBS follow-up practices to better evaluate and understand the multi-level, state-specific processes of how each state’s public health department delivers the NBS results to families, how/if they ensure affected infants are seen quickly by sickle cell specialists, and to determine the close-out processes used in each state. This project used semi-structured interviews conducted with 29 participants across eight states to explore these NBS follow-up processes in each state. Participants included SCD providers, NBS coordinators, or personnel associated with state health departments and community-based SCD organizations (CBO). Our results show significant state-dependent variations in the NBS processes of information delivery and patient management. Specifically, programs differed in how they communicated results to affected families and which other organizations were informed of the diagnosis. There was also state-based (and intrastate) variation in who should assume responsibility for ensuring that infants receive confirmatory testing and are promptly started on penicillin prophylaxis. Case closure was also highly variable and poorly validated. Our results also yielded identifiable challenges and facilitators to NBS which were highly variable by state but potentially addressable in the future. This information suggests opportunities for systematic improvement in NBS follow-up processes.https://www.mdpi.com/2409-515X/10/1/22newborn screeningsickle cell diseasefollow upqualitative interviews |
| spellingShingle | Najibah Galadanci Shannon Phillips Alyssa Schlenz Nataliya Ivankova Julie Kanter Current Methods of Newborn Screening Follow-Up for Sickle Cell Disease Are Highly Variable and without Quality Assurance: Results from the ENHANCE Study International Journal of Neonatal Screening newborn screening sickle cell disease follow up qualitative interviews |
| title | Current Methods of Newborn Screening Follow-Up for Sickle Cell Disease Are Highly Variable and without Quality Assurance: Results from the ENHANCE Study |
| title_full | Current Methods of Newborn Screening Follow-Up for Sickle Cell Disease Are Highly Variable and without Quality Assurance: Results from the ENHANCE Study |
| title_fullStr | Current Methods of Newborn Screening Follow-Up for Sickle Cell Disease Are Highly Variable and without Quality Assurance: Results from the ENHANCE Study |
| title_full_unstemmed | Current Methods of Newborn Screening Follow-Up for Sickle Cell Disease Are Highly Variable and without Quality Assurance: Results from the ENHANCE Study |
| title_short | Current Methods of Newborn Screening Follow-Up for Sickle Cell Disease Are Highly Variable and without Quality Assurance: Results from the ENHANCE Study |
| title_sort | current methods of newborn screening follow up for sickle cell disease are highly variable and without quality assurance results from the enhance study |
| topic | newborn screening sickle cell disease follow up qualitative interviews |
| url | https://www.mdpi.com/2409-515X/10/1/22 |
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