Early discharge from the newborn nursery-effect on scheduling of follow-up visits by pediatricians

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.