Early Discharge From the Newborn Nursery—Effect on Scheduling of Follow-up Visits by Pediatricians

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Abstract
Objective. To evaluate the impact of shorter hospital stays on the follow-up scheduling of newborn infants by private pediatricians. Design. Five surveys over a period of 18 months with educational intervention. Setting. Large community hospital well baby nursery. Participants. Twenty private pediatricians who cared for at least 20 newborn infants in the well baby nurseries during 1995. Intervention. Oral and written communications to pediatricians emphasizing the importance of evaluating infants within 2 to 3 days of discharge if the hospital stay was less than 48 hours. Main outcome measure. Interval between discharge from the nursery and the scheduled follow-up visit to the pediatrician. Results. In the first two surveys (September 1994 and March 1995) there was no significant difference in follow-up scheduling by pediatricians for those infants discharged <48 hours vs ≥48 hours. Differences were significant in July and November 1995, and in the final survey in March 1996. Nevertheless, in March 1996, 38% of short-stay infants were scheduled to be seen 4 or more days after discharge, and 33% 14 days after discharge. Conclusion. Although follow-up practices have changed in response to shorter newborn hospital stays, a significant proportion of pediatricians are not following the American Academy of Pediatrics guidelines for the follow-up of short-stay infants. Whether or not failure to follow these guidelines will lead to an increase in morbidity is unknown.