EARLY DISCHARGE FROM THE NEWBORN NURSERY - EFFECT ON SCHEDULING OF FOLLOW-UP VISITS BY PEDIATRICIANS

Objective. To evaluate the impact of shorter hospital stays on the fol low-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. Tw enty private pediatricians who cared for at least 20 newborn infants i n the well baby nurseries during 1995. Intervention. Oral and written communications to pediatricians emphasizing the importance of evaluati ng infants within 2 to 3 days of discharge if the hospital stay was le ss than 48 hours. Main outcome measure. Interval between discharge fro m the nursery and the scheduled follow-up visit to the pediatrician. R esults. In the first two surveys (September 1994 and March 1995) there was no significant difference in follow-up scheduling by pediatrician s for those infants discharged <48 hours vs greater than or equal to 4 8 hours. Differences were significant in July and November 1995, and i n 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 disc harge, 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 Ameri can Academy of Pediatrics guidelines for the follow-up of short-stay i nfants. Whether or not failure to follow these guidelines will lead to an increase in morbidity is unknown.