{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T13:14:24Z","timestamp":1790255664893,"version":"4.1.0"},"reference-count":33,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,6,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>Substantial variability exists in hyperbilirubinemia screening and monitoring leading to unnecessary total serum bilirubin (TSB) testing in healthy newborns. We aimed to assess the impact of value-care interventions to decrease the monthly TSB testing rate per 100 patient-days among healthy newborns in our Mother-Baby Unit by 30% by June 2022.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>We formed a multidisciplinary team to review the current practice for ordering TSB among housestaff in our Mother-Baby Unit. We identified several themes: variation in clinical practice, fear of hyperbilirubinemia, and desire to act for high-intermediate risk bilirubin levels. The interventions consisted of obtaining faculty buy-in, redesigning the hyperbilirubinemia pathway, educating staff on high value-care, producing an instructional video, and prompting staff to incorporate a bilirubin risk assessment via smart phrases in our electronic health record. The primary outcome was the monthly TSB testing rate per 100 patient-days. Universal predischarge bilirubin screening, length of stay, phototherapy rates, and readmission rates were chosen as balancing measures.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>The monthly rate of TSB testing was reduced from 51 to 26.3 TSB per 100 patient-days, representing a 48% reduction. This improvement was sustained for 12 months. The percentage of infants with at least 1 TSB measurement during birth hospitalization decreased from 48% to 30%. Predischarge bilirubin screening, length of stay, and readmission rates were unchanged.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Our quality improvement initiative led to a significant reduction in the monthly TSB testing per 100 patient-days in healthy newborns without evidence of harm.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2022-059474","type":"journal-article","created":{"date-parts":[[2023,5,12]],"date-time":"2023-05-12T08:10:30Z","timestamp":1683879030000},"source":"Crossref","is-referenced-by-count":9,"title":["Decreasing Bilirubin Serum Tests in Healthy Newborns During Birth Hospitalization"],"prefix":"10.1542","volume":"151","author":[{"given":"Sarah","family":"Sukkar","sequence":"first","affiliation":[{"name":"aHoltz Children\u2019s Hospital at Jackson Memorial Hospital, Miami, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella","family":"Lorusso","sequence":"additional","affiliation":[{"name":"aHoltz Children\u2019s Hospital at Jackson Memorial Hospital, Miami, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Jananeh","sequence":"additional","affiliation":[{"name":"aHoltz Children\u2019s Hospital at Jackson Memorial Hospital, Miami, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin","family":"Harrison","sequence":"additional","affiliation":[{"name":"aHoltz Children\u2019s Hospital at Jackson Memorial Hospital, Miami, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikki-Ann","family":"Martin","sequence":"additional","affiliation":[{"name":"aHoltz Children\u2019s Hospital at Jackson Memorial Hospital, Miami, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evan","family":"Grabois","sequence":"additional","affiliation":[{"name":"aHoltz Children\u2019s Hospital at Jackson Memorial Hospital, Miami, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco Castillo","family":"Ayarza","sequence":"additional","affiliation":[{"name":"aHoltz Children\u2019s Hospital at Jackson Memorial Hospital, Miami, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reeja","family":"Raj","sequence":"additional","affiliation":[{"name":"aHoltz Children\u2019s Hospital at Jackson Memorial Hospital, Miami, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Cohen","sequence":"additional","affiliation":[{"name":"aHoltz Children\u2019s Hospital at Jackson Memorial Hospital, Miami, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayati","family":"Pal","sequence":"additional","affiliation":[{"name":"aHoltz Children\u2019s Hospital at Jackson Memorial Hospital, Miami, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Garcia-Chacon","sequence":"additional","affiliation":[{"name":"bDepartment of Pediatrics, Section of Hospital Medicine"},{"name":"cMiller School of Medicine, University of Miami, Miami, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liz Y.","family":"Bayes","sequence":"additional","affiliation":[{"name":"bDepartment of Pediatrics, Section of Hospital Medicine"},{"name":"cMiller School of Medicine, University of Miami, Miami, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2023,5,12]]},"reference":[{"issue":"1","key":"2023111014182449900_B1","first-page":"297","article-title":"Management of 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