Newborn Screening Collection and Delivery Processes in Michigan Birthing Hospitals: Strategies to Improve Timeliness

  • Amy L. Cochran
  • Beth A. Tarini
  • Mary Kleyn
  • Gabriel Zayas-Cabán


Objectives This study aimed to determine which steps in the newborn screening collection and delivery processes contribute to delays and identify strategies to improve timeliness. Methods Data was analyzed from infants (N = 94,770) who underwent newborn screening at 83 hospitals in Michigan between April 2014 and March 2015. Linear mixed effects models estimated effects of hospital and newborn characteristics on times between steps in the process, whereas simulation explored how to improve timeliness through adjustments to schedules for the state laboratory and for specimen pickup from hospitals. Results Time from collection to receipt of arrival to the state laboratory varied greatly with collection timing (P < 0.001), with specimens collected on Friday or Saturday delayed an average of 9–12 h compared to other specimens. Simulation estimates shifting specimen pickup from 6 p.m. Sunday–Friday to 9 p.m. Sunday–Friday could lead to an additional 12.6% of specimens received by the Michigan laboratory within 60 h of birth. Conclusions for Practice The time between when a specimen is collected and received by the laboratory can be a significant bottleneck in the newborn screening process. Modifying hospital pickup schedules appears to be a simple way to improve timeliness.


Newborn screening Genetic testing Newborn screening process Simulation model 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

10995_2018_2524_MOESM1_ESM.docx (136 kb)
Supplementary material 1 (DOCX 135 KB)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Biostatistics and Medical InformaticsUniversity of Wisconsin-MadisonMadisonUSA
  2. 2.Department of PediatricsUniversity of IowaIowa CityUSA
  3. 3.Department of PediatricsUniversity of MichiganAnn ArborUSA
  4. 4.Michigan Department of Health and Human ServicesLansingUSA
  5. 5.Industrial and Systems EngineeringUniversity of Wisconsin-MadisonMadisonUSA

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