Online Program

286212
Critical congenital heart disease (CCHD) screening practices and plans to implement routine pulse oximetry screening among Massachusetts hospitals and birth centers


Tuesday, November 5, 2013

Katherine Flaherty, ScD, U.S. Health Division, Public Health and Epidemiology, Abt Associates, Cambridge, MA
Alice Lee, U.S. Health Division, Public Health and Epidemiology, Abt Associates, Cambridge, MA
Marlene Anderka, Massachusetts Center for Birth Defects Research and Prevention, Massachusetts Department of Public Health, Boston, MA
Cathleen Higgins, Massachusetts Center for Birth Defects Research and Prevention, Massachusetts Department of Public Health, Boston, MA
Background: Following the 2011 recommendation from the Secretary of Health and Human Services to incorporate CCHD screening using pulse oximetry in the routine assessment of the newborn, the birth defects monitoring program at the Massachusetts Department of Public Health (MDPH) convened a time-limited work group to advise the department on its response to the Secretary's recommendation. MDPH assessed current screening practices and plans to implement the screening among Massachusetts hospitals and birth centers as part of the evidence developed for the work group's consideration.

Methods: Surveys were mailed to all 47 maternity hospitals and two birth centers in the state. The survey included questions about the hospital's screening protocol; plans for implementation; and capacity for follow-up diagnosis, treatment, and referrals for positive screens.

Results: MDPH received responses from all hospitals and birth centers. Whereas the two birth centers did not routinely screen for CCHD, 11 of the 47 hospitals (23%) reported performing the screening at the time of the survey. Of the 36 hospitals that reported not performing the screening, 19 (40%) had plans to implement screening, and 12 (26%) were still considering the screening. Four (9%) had not considered screening, and one hospital had decided against implementation. A comparison of hospital protocols in use revealed wide variation, including in the timing of screens, oxygen saturation thresholds, and follow-up procedures.

Conclusion: Members present at the final work group meeting unanimously agreed that MDPH should provide a single set of hospital screening guidelines to facilitate a more coordinated approach to implementation.

Learning Areas:

Public health or related laws, regulations, standards, or guidelines

Learning Objectives:
Describe the potential role of birth defects surveillance programs in coordinating a statewide approach to a new screening recommendation on the Recommended Uniform Screening Panel (RUSP)

Keyword(s): Birth Defects, Screening

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have more than 25 years of MCH experience. For the past four years, I have been a senior consultant to the Massachusetts Center for Birth Defects and Research. In this role, I advise on the implementation of surveillance regulations in maternity hospitals, have organized a CCHD screening advisory committee, and conducted a CCHD hospital survey. I also am currently the lead of provider reporting for a CHD surveillance project in Massachusetts.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.