SC hospitals slow in getting newborn tests to lab

01/30/2014 8:08 PM

01/31/2014 9:07 AM

South Carolina hospitals had a problem they didn’t recognize until a Wisconsin journalist asked for data on turnaround time for newborn blood test results.

Seven months later, health officials in the state know they have been doing a poor job in getting those tests quickly to the state lab, and they have started the process to change that.

“Until we saw this data, we didn’t know that it was a problem,” said Rick Foster, senior vice president of quality and patient safety at the S.C. Hospital Association. “We’re in the process of working with each hospital to make sure the samples get to the lab as quickly as possible.”

The tests check for a variety of potentially deadly conditions that occur in about one in every 800 babies. Since recognizing the problem, South Carolina health leaders have checked records to determine if delayed test results led to any severe consequences or deaths. They haven’t been able to find any, Foster said.

But the situation was troubling enough that S.C. Department of Health and Environmental Control and state hospitals are changing the way the hospitals handle the tests. The agency also is hiring two additional lab technicians to prevent the state’s central lab from being closed two days a week, spokesman Mark Plowden said.

The Milwaukee Journal Sentinel started looking into delays in newborn screening lab results last year after a physician there brought a case to her attention. The doctor was upset that he had to take extraordinary measures to save the life of a newborn after the local hospital had delayed sending off the blood work to batch that sample with others, apparently to save money.

The blood tests, required by the federal government, can detect genetic disorders that can kill newborns or cause them to become extremely ill if not detected quickly. Federal guidelines recommend the samples be tested in no more than three days.

Taking the blood samples for the tests has long been part of the routine at hospitals, but many states – including South Carolina – didn’t track the speed at which the lab results were returned.

Reporter Ellen Gabler wrote a follow-up story this week, taking South Carolina to task for taking seven months to provide specific hospital data, on the turnaround time for the blood test results and for the poor performance by the state’s hospitals. Foster said it took that long to compile the data for the first time.

(Twenty states and the District of Columbia still haven’t provided the data requested by the Milwaukee Journal Sentinel.)

The S.C. findings were distressing. Only about 25 percent of samples made it to the lab in three days, and 33.75 percent took five or more days. That’s the worst five-day percentage of any of the states that have provided the Journal Sentinel data. Only two of the states providing data had more than 20 percent of samples take five days or more – South Carolina and Maryland (33.54).

The longest delays in South Carolina were mostly in the Upstate – with 70 percent of samples from AnMed Health in Anderson and from Novant Health Gaffney Medical Center taking more than five days. Other hospitals with more than 60 percent of samples taking more than five days were Greer Memorial Hospital (62) and Piedmont Medical Center in Rock Hill (63).

There were fewer five-day delays across the board in the Midlands – 24.41 percent at Palmetto Health Richland, 10.32 at Lexington Medical Center, 8.62 at Palmetto Health Baptist, 8.01 at Tuomey Healthcare System in Sumter and 2.78 at KershawHealth in Camden.

State health officials still are looking into the regional differences in turnaround time, but the distance from the central DHEC lab appears to be a factor. The state agency doesn’t plan to open new labs, but it will be adding personnel to prevent being closed on weekends, Plowden said.

The state agency also is working with the hospital association to determine the fastest courier method for the samples, which could differ in various regions of the state, Plowden said.

Foster said hospitals will be discouraged from waiting to batch samples and will be encouraged to make sure all samples are shipped within 24 hours of being taken.

At Greenville Memorial Hospital, where more than 5,300 babies were born last year, nearly 48 percent of blood samples took five or more days to reach the lab. Hospital managers pledged to do better.

“We want our state to be the best and our hospitals to be the best,” Jennifer Hudson, medical director of newborn services for Greenville Health Systems, told the Journal Sentinel. “If we have shortcomings, we want to fix it.”

The timing is good for changes in the process because DHEC this year is expanding its panel of newborn screening tests to include a new test for Severe Combined Immunodeficiency, which results in an inability to fight infection. SCID more commonly is called Bubble Boy Disease. South Carolina will be one of 20 states testing for SCID.

Procedures and paperwork were going to have to be changed to include that new test. Other new procedures, and a new data management system at DHEC, will make it easier to track the timeliness of blood samples, the state agency said.

DHEC began newborn blood testing in 1965. It currently screens for 52 conditions that can cause problems if not found early in life.

Read more about newborn testing and view Interactive map

Click here to read the Milwaukee Journal Sentinel’s series on the dangers of delaying screening lab tests.

Newborn Screening by thestate

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