Community Neo-natal Jaundice Pathway: Improving Safety and Acceptability
Leads: Dr Beck Taylor (Maternity), Dr Katharine Reeves (Meths)
The team are working with public contributors from ARC WM’s Maternity Theme throughout the project.
Dates: November 2019 - TBC
One in five admissions to neonatal units from home in the UK are due to jaundice. Through focus groups and multidisciplinary workshops in Birmingham and Solihull, which included a public contributor, inefficiencies have been identified in the community neonatal jaundice pathway. Improved availability of routine data and opportunities for data linkage means that it is now possible to measure and explore the activity, inefficiencies and opportunities identified in the pathway.
Policy and Practice Partners:
Birmingham Womens and Children’s NHS Foundation Trust and University Hospitals Birmingham. . Partners include clinical scientists from the laboratories, midwives, and neonatologists at the trusts.
University Hospital Birmingham NHS Foundation Trust, Birmingham Women's and Children's Hospital NHS Foundation Trust,
Aims and Objectives:
This study aims to understand how neonatal jaundice is assessed and diagnosed, and the incidence of community-diagnosed neonatal jaundice in babies in Birmingham and Solihull. The findings will be used to scope and plan pathway improvements, such as near patient testing, which can be scaled up and implemented more widely across the UK.
Design: cross sectional observational study.
Setting: Birmingham and Solihull Local Maternity System (LMS).
Participant population: approximately 20,000 babies born since the launch of the BadgerNet electronic patient record (April 2019), and cared for postnatally by community midwives between 24 hours and 10 days after birth.
Measures: demographics, process and outcome measures, including suspected jaundice, transcutaneous and serum bilirubin tests, diagnoses of jaundice, and referrals and admissions for treatment.
Analysis: summary statistics (frequency, %, and for continuous data mean and median). Two-sample t-test to test and Pearson’s chi-squared test to explore variation between groups.
Analysis in progress.
Project still underway.
Implications for Implementation:
Designing and implementing an improved care pathway incorporating decision support into merged laboratory and midwifery pathways.