{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T14:46:55Z","timestamp":1746715615506,"version":"3.40.5"},"reference-count":14,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,2,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>The purpose of this study was to minimize unnecessary laboratory services for hospitalized neonates with hyperbilirubinemia by revising a local clinical practice pathway (CPP).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>A retrospective cohort study was performed to compare the number of laboratory tests and blood draws in patients hospitalized with neonatal hyperbilirubinemia before and after implementation of a revised CPP. The study included infants with neonatal hyperbilirubinemia &amp;lt;14 days old admitted after their birth hospitalization between April 2017 and October 2019. Primary outcome measures included the total number of blood draws and the number of laboratory tests obtained per patient and length of stay. Secondary outcome measures included 7-day readmission rate, charges, and discharge bilirubin level.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>The median number of blood draws per patient after implementation of the CPP decreased to 2 (interquartile range [IQR], 2\u20133) compared with 3 (IQR, 2\u20133) before implementation (Poisson model\u2013based estimated mean difference, 1.1; 95% confidence interval, 1.0\u20131.3; P = .018). The median number of laboratory tests per patient after implementation decreased from 4 (IQR, 3\u20136) to 3 (IQR, 2\u20134; Poisson model\u2013based estimated mean difference, 1.3; 95% confidence interval, 1.2\u20131.5; P &amp;lt; .0001). There was no significant change in length of stay, readmission rate, charges, or discharge bilirubin level.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Implementation of a revised CPP was associated with a significant decrease in the number of blood draws and laboratory tests per patient for infants admitted to the hospital for neonatal hyperbilirubinemia.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/hpeds.2021-006019","type":"journal-article","created":{"date-parts":[[2022,1,5]],"date-time":"2022-01-05T08:13:24Z","timestamp":1641370404000},"page":"e67-e72","source":"Crossref","is-referenced-by-count":4,"title":["Decreasing Laboratory Testing for Neonatal Jaundice Through Revision of a Clinical Practice Pathway"],"prefix":"10.1542","volume":"12","author":[{"given":"Erin","family":"Preloger","sequence":"first","affiliation":[{"name":"Children\u2019s Wisconsin, Milwaukee, Wisconsin"},{"name":"Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Wedoff","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina, Charleston, South Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer T.","family":"Lemke","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anika","family":"Nelson","sequence":"additional","affiliation":[{"name":"Children\u2019s Wisconsin, Milwaukee, Wisconsin"},{"name":"Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2022,1,5]]},"reference":[{"issue":"8","key":"2022020117470147700_b1","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1542\/pir.32.8.341","article-title":"Hyperbilirubinemia in the newborn","volume":"32","author":"Lauer","year":"2011","journal-title":"Pediatr Rev"},{"issue":"3","key":"2022020117470147700_b2","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1016\/j.jpeds.2012.08.022","article-title":"Predischarge screening for severe neonatal hyperbilirubinemia identifies infants who need phototherapy","volume":"162","author":"Bhutani","year":"2013","journal-title":"J Pediatr"},{"issue":"1","key":"2022020117470147700_b3","doi-asserted-by":"crossref","first-page":"e170","DOI":"10.1542\/peds.2006-3499","article-title":"A comparison of alternative risk-assessment strategies for predicting significant neonatal hyperbilirubinemia in term and near-term infants","volume":"121","author":"Keren","year":"2008","journal-title":"Pediatrics"},{"issue":"10","key":"2022020117470147700_b4","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1542\/hpeds.2020-0161","article-title":"Variation in Care and Clinical Outcomes Among Infants Hospitalized With Hyperbilirubinemia","volume":"10","author":"DePorre","year":"2020","journal-title":"Hosp Pediatr"},{"volume-title":"Understanding Value-Based Healthcare","year":"2015","author":"Moriates","key":"2022020117470147700_b5"},{"issue":"3","key":"2022020117470147700_b6","doi-asserted-by":"crossref","first-page":"e20161472","DOI":"10.1542\/peds.2016-1472","article-title":"Neonatal jaundice: improved quality and cost savings after implementation of a standard pathway","volume":"141","author":"Romero","year":"2018","journal-title":"Pediatrics"},{"issue":"1","key":"2022020117470147700_b7","first-page":"297","article-title":"Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation [published correction appears in Pediatrics. 2004;114(4):1138]","volume":"114","author":"American Academy of Pediatrics Subcommittee on Hyperbilirubinemia","year":"2004","journal-title":"Pediatrics"},{"key":"2022020117470147700_b8","unstructured":"National Institute for Health and Care Excellence. Jaundice in newborn babies under 28 days. Available at: https:\/\/www.nice.org.uk\/Guidance\/CG98. Accessed July 21, 2021"},{"key":"2022020117470147700_b9","unstructured":"Migita\n              D\n            , HerrmanA, FenstermacherSet al; Seattle Children\u2019s Hospital. Neonatal jaundice pathway. Available at: https:\/\/www.seattlechildrens.org\/pdf\/neonatal-jaundice-pathway.pdf. Accessed August 6, 2021"},{"key":"2022020117470147700_b10","unstructured":"Liu\n              N\n            , GamulkaB, VallipuramJ, JafferA, RajwaniFA; The Hospital for Sick Children. Inpatient Hyperbilirubinemia Management. Available at: https:\/\/wapps.sickkids.ca\/clinical-practice-guidelines\/clinical-practice-guidelines\/Export\/CLINS363\/Main%20Document.pdf. Accessed August 6, 2021"},{"key":"2022020117470147700_b11","unstructured":"Sroufe\n              NS\n            , VredeveldJL, GoodsonSLet al; University of Michigan Health System. Management of indirect neonatal hyperbilirubinemia. Available at: www.med.umich.edu\/1info\/FHP\/practiceguides\/InptHyperbili\/Hyperbili.pdf. Accessed August 6, 2021"},{"issue":"2","key":"2022020117470147700_b12","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1111\/j.1651-2227.2008.01015.x","article-title":"When should phototherapy be stopped? A pilot study comparing two targets of serum bilirubin concentration","volume":"98","author":"Barak","year":"2009","journal-title":"Acta Paediatr"},{"issue":"7","key":"2022020117470147700_b13","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1007\/s13312-010-0133-z","article-title":"Bilirubin rebound after intensive phototherapy for neonatal jaundice","volume":"47","author":"Bansal","year":"2010","journal-title":"Indian Pediatr"},{"issue":"2","key":"2022020117470147700_b14","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1542\/hpeds.2014-0074","article-title":"The utility of inpatient rebound bilirubin levels in infants readmitted after birth hospitalization for hyperbilirubinemia","volume":"5","author":"Berkwitt","year":"2015","journal-title":"Hosp Pediatr"}],"container-title":["Hospital Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/hospitalpediatrics\/article-pdf\/12\/2\/e67\/1255404\/hpeds.2021-006019.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/hospitalpediatrics\/article-pdf\/12\/2\/e67\/1255404\/hpeds.2021-006019.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,1]],"date-time":"2022-02-01T17:53:15Z","timestamp":1643737995000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/hospitalpediatrics\/article\/12\/2\/e67\/184393\/Decreasing-Laboratory-Testing-for-Neonatal"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,5]]},"references-count":14,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,1,5]]},"published-print":{"date-parts":[[2022,2,1]]}},"URL":"https:\/\/doi.org\/10.1542\/hpeds.2021-006019","relation":{},"ISSN":["2154-1663","2154-1671"],"issn-type":[{"type":"print","value":"2154-1663"},{"type":"electronic","value":"2154-1671"}],"subject":[],"published":{"date-parts":[[2022,1,5]]}}}