{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T01:00:11Z","timestamp":1790211611659,"version":"4.1.0"},"reference-count":21,"publisher":"American Academy of Pediatrics (AAP)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To assess whether anticipated weekend follow-up and\/or bilirubin rate of rise (ROR) were associated with subthreshold phototherapy (STP) following implementation of the 2022 American Academy of Pediatrics clinical practice guidelines (CPG).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PATIENTS AND METHODS<\/jats:title>\n                    <jats:p>A retrospective review of infants 35 or more weeks\u2019 gestational age who received inpatient phototherapy between 0 to 14 days of life across 5 hospitals (1 academic and 4 community) in 1 health system from February 2022 to January 2024 was performed. Cases were divided into pre-CPG (6 months before guidelines), washout (0\u20136 months after guidelines) and post-CPG (6\u201318 months after guidelines) and compared by hospital site. Cases were sorted by high vs low ROR (\u22650.2 mg\/dL\/h or &amp;lt;0.2 mg\/dL\/h, respectively) based on the CPG categories and by weekday or weekend follow-up; associations with STP were examined using chi-square and logistic regressions in SPSS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 1520 cases were identified. Overall STP decreased post-CPG (51% post-CPG vs 64% pre-CPG; P &amp;lt; .001) with significant change only in community sites (74% pre-CPG vs 55% post-CPG; P &amp;lt; .01). Weekend follow-up among all sites was associated with STP both pre-CPG (weekend vs nonweekend, 76% vs 59%; P &amp;lt; .001) and post-CPG (60% vs 48%; P = .010). Infants receiving STP were more likely to have high ROR post-CPG (57% vs 47%; P = .035); when stratified, this difference was only in the academic site (60% post-CPG vs 29% pre-CPG; P = .004).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>CPG implementation was associated with overall decreased STP, driven by community hospitals. Weekend follow-up and high ROR were associated with STP postguideline. Real-world uptake of the revised CPG was influenced not only by new clinical thresholds but also by practice setting and anticipated weekend follow-up access.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/hpeds.2026-009498","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:03:15Z","timestamp":1790208195000},"source":"Crossref","is-referenced-by-count":0,"title":["Barriers to Implementing the 2022 Clinical Practice Guidelines for Neonatal Hyperbilirubinemia"],"prefix":"10.1542","author":[{"given":"Preeta A.","family":"Kamat","sequence":"first","affiliation":[{"name":"1Northwestern University Feinberg School of Medicine, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uma","family":"Thachapuzha","sequence":"additional","affiliation":[{"name":"1Northwestern University Feinberg School of Medicine, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joy M.","family":"Koopmans","sequence":"additional","affiliation":[{"name":"1Northwestern University Feinberg School of Medicine, Chicago, Illinois"},{"name":"2Ann & Robert H. Lurie Children\u2019s Hospital of Chicago, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malika D.","family":"Shah","sequence":"additional","affiliation":[{"name":"1Northwestern University Feinberg School of Medicine, Chicago, Illinois"},{"name":"2Ann & Robert H. 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