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This was an innovation project supported by the former Better Care Victoria Innovation Fund.

Lead organisation

The Royal Women’s Hospital (the Women’s)

Summary

Before this project, the Women’s newborn jaundice care pathway involved having midwives screen babies for jaundice in their homes. If high levels of the jaundice-causing substance bilirubin were detected in the skin, baby and mother were referred to the Women’s Emergency Care for a further blood test. If this test indicated that treatment was required, mother and baby would be admitted as inpatients for phototherapy.

In 2017, the Women’s developed a new care pathway for newborns with jaundice to allow parents to spend more time bonding with their babies in the comfort of home. By expanding its existing services to enable the assessment and treatment of newborns with jaundice in the home, the health service reduced disruption during the important postnatal period, saved parents the time and cost of travelling to hospital, and decreased the number of babies presenting to the Women’s Emergency Care for jaundice care.

Aims

  • Enable more mothers and babies to stay together at home in the immediate postnatal period by assessing the jaundiced newborn and managing care at home, where clinically appropriate
  • Reduce the need for newborns with jaundice to present to the Women’s Emergency Care
  • Release maternity inpatient bed resources

Outcomes

  • Reduced newborn jaundice emergency care presentations by 52 per cent
  • Enabled phototherapy treatment at home, releasing an estimated 329 maternity bed/cot bed days and allowing more mothers and babies to stay together during the immediate postnatal period
  • Improved patient care and experience, with 70 per cent of post-project survey respondents saying the care they received allowed them to establish a routine at home and 70 per cent rating their overall experience as very good

Update

November 2019 – The Women’s has integrated the new project pathways into its maternity and neonatal services. The initiative was showcased as a quality improvement project as part of the hospital’s accreditation in March 2019 and was highly commended in the Clinical Excellence and Patient Safety category for the Australian Council on Healthcare Standards’ 22nd Annual Quality Improvement Awards in 2019. 

View the ‘Jaundice and Phototherapy’ educational videos on the Women’s website.

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