Background: In 2008, the Israel Neonatal Society (INS) called for universal surveillance for hyperbilirubinemia by a health care professional within 2-3 days of discharge from birth hospitalization. As part of a study on post-discharge newborn follow-up, we found low rates of recommendation adherence in general but almost perfect compliance to specific requests for bilirubin testing. We then chose to study relevant follow-up instructions in newborn discharge letters from Israeli hospitals.
Objective: To determine the if written discharge instructions were specific and consistent with INS guidelines
Design/Methods: Neonatology department directors of 29 hospitals with delivery services were approached to provide a sample discharge letter. Letters were reviewed to determine if follow-up was instructed to occur within 3 days of discharge, as per the guideline, and was the term follow up for jaundice specifically mentioned.
Results: Letters were received from 26/29 eligible hospitals. Seven (27%) did not give any specific time frame. Of the 19 that gave a time frame, 15 (58%) recommended within 72 hours. Only 14/26 (54%) mentioned that follow up was needed for jaundice such that only 12/26 (46%) contained both the 72 hour time frame and the reason for this follow up.
Conclusion(s): Despite ratification of INS guidelines by ≥70% of neonatal departments, written instructions reflecting the guidelines, and likely to facilitate achieving its aim, are not consistently incorporated in discharge letters from Israeli hospitals. Such inexplicit and inconsistent written instructions may be contributing to poor post-discharge community follow-up for hyperbilirubinemia.
