State adds reporting on newborn testing

Hospital chiefs to get lab-time briefs

The Arkansas Department of Health plans this week to start sending hospital administrators reports showing them how quickly the blood samples collected from newborns are submitted to the department laboratory in Little Rock for testing, a department spokesman said Friday.

Health Department spokesman Kerry Krell said department officials decided to start sending the reports after the Milwaukee Journal Sentinel reported last month that thousands of samples a year arrive at laboratories five or more days after they are collected - two days longer than the delivery time recommended in a report by the American College of Medical Genetics.

In Arkansas, a Health Department spokesman told the Arkansas Democrat-Gazette last month that only 13 percent of the more than 36,000 samples collected from newborns in the fiscal year that ended June 30 made it to the department’s laboratory in Little Rock within the department’s target time span of 48 hours.

That was an improvement from the fiscal year that ended June 30, 2011, when only 8 percent of the samples arrived at the laboratory within 48 hours.

The department tests the blood samples for 28 disorders. In some cases, department officials say, early diagnosis can allow treatment to start in time to save a baby’s life or prevent permanent damage.

In the past state fiscal year, 80 babies were diagnosed with genetic disorders as a result of the newborn screenings.

“It’s very important for hospitals to understand how important this is,” Krell said.

The department has sent hospital nursery managers information on blood sample delivery times since 2008, when it hired a nurse educator to help improve the quality of the samples collected and the speed at which they are sent to the state laboratory, Krell said.

The department hopes that sending the information to the hospital administrators will prompt more hospitals to improve their procedures, she said.

“Sometimes, if your boss gets the information, instead of you, your boss has a little more influence over you,” Krell said.

Hospital administrators “understand all the pieces of the puzzle that have to come together on the hospital level in order to get the samples to the lab,” she added.

The reports will show hospital administrators the performances of their hospitals compared with others, but won’t name the other hospitals, she said. The reports likely will be sent every quarter or twice a year.

The department has declined to publicly release information on individual hospital performance in submitting the blood samples. It cited Arkansas Code 20-9-221, which prohibits the department’s Division of Health Facilities Services from releasing information identifying “individuals or institutions except in a proceeding involving the question of licensing or revocation of a license.”

Bo Ryall, a spokesman for the Arkansas Hospital Association, said the reports sent to administrators will help them review their hospitals’ practices.

“Hospitals want to be responsive,” Ryall said. “They want to work more closely with the Health Department to improve this process, make it more efficient and get the samples to the lab in a timely manner.”

The Milwaukee Journal Sentinel story reported that a sample drawn from baby at Arkansas Methodist Hospital in Paragould was not tested at the Health Department laboratory until 3½ weeks after the baby was born in 2011.

As a result of the test, the baby, Aiden Cooper, was diagnosed with galactosemia, a disorder that prevented his body from digesting galactose, a sugar in breast milk and traditional formula.

By the time the boy’s mother learned of the diagnosis, he had already spent two weeks at Arkansas Children’s Hospital in Little Rock, where he was rushed by ambulance after developing a rash and swollen stomach, the Journal Sentinel reported.

According to the U.S. Library of Medicine’s website, infants with the most common and severe form of galactosemia who are not given a low galactose diet can develop life-threatening complications within a few days of birth.

Affected children are at increased risk of delayed development, cataracts, speech difficulties and intellectual disability, according to the website.

The American College of Medical Genetics report recommended that newborn screening samples, which are taken by pricking the heel of a baby and collecting blood on drops of filter paper, be submitted for analysis within three days of collection and that the results be available no later than two days after that - a total turnaround time of five days.

State Board of Health regulations say hospitals should collect blood samples from newborns 24 to 72 hours after birth and submit the samples to the laboratory within 48 hours of collection.

The regulations also say that the laboratory should analyze samples within five working days of receiving them and that any abnormal result should be communicated within two working days after the initial analysis is performed.

The laboratory is closed on weekends and state holidays, including Thanksgiving, Christmas and Christmas Eve, and on the day after Thanksgiving, when state offices are closed by a governor’s proclamation.

A department-run courier service that delivers samples from county health units to the laboratory does not operate when the laboratory is closed.

Expanding the laboratory’s hours to include weekends and holidays is “a challenge we’re trying to figure out,” Krell said.

She said the department encourages hospitals to send samples using overnight shipping services, such as FedEx, when the laboratory is closed.

On days the Health Department courier service is available, about half of the hospitals use it, while others use FedEx, UPS or the U.S. Postal Service, department spokesman Ed Barham said last month.

Some hospitals also collect multiple days’ worth of samples before delivering them to the Health Department even though the department encourages the hospitals to send the samples every day.

A spokesman for Washington Regional Medical Center in Northwest Arkansas said last month that the hospital delivers samples to the nearby county health unit only on Mondays, Wednesdays and Fridays. Spokesman Terry Fox didn’t return a phone message Friday.

Representatives of UAMS Medical Center and St. Vincent Infirmary Medical Center, both in Little Rock, and St. Bernards Medical Center in Jonesboro each said last month that their samples are delivered to the Health Department daily, Monday through Friday, either by hospital personnel or the Health Department courier.

Baptist Health System uses a private courier to deliver samples five days a week from its hospitals in Little Rock and North Little Rock to the Health Department laboratory and from the system’s hospitals in Stuttgart and Arkadelphia to county health units, spokesman Mark Lowman said Friday. The system’s Heber Springs hospital does not deliver babies.

Lowman said the system already tracks information on the delivery time of the samples, so the Heath Department reports “wouldn’t be new information.”

Northwest Health System sends the samples daily to the laboratory through FedEx overnight Monday through Friday from its hospital in Bentonville, and through FedEx or the Health Department courier Monday through Saturday from its women’s hospital in Johnson, spokesman Patricia Driscoll said. The system’s Springdale hospital does not deliver babies.

She said the Health Department reports will be useful.

“Anywhere you can improve communications, whether it’s between departments or between organizations, it’s got to help,” she said.

Front Section, Pages 1 on 12/15/2013

Upcoming Events