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

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.