Children's National Staff Contribute to National Recommendations on Screening All Newborns for Critical Congenital Heart Disease

Washington, DC—Gerard R. Martin, MD, Senior Vice President of the Center for Heart, Lung and Kidney Disease at Children’s National Health System, is the lead author of new national recommendations for implementing routine screening for critical congenital heart disease (CCHD) in newborns.

The recommendations, published in the July 2013 issue of Pediatrics, address challenges and areas for further attention as hospitals and state health departments move forward with implementing CCHD screening. In 2011, the U.S. Secretary of Health and Human Services endorsed CCHD as part of the recommended uniform screening tests for newborns.

“As states, hospitals, and other facilities work to make it routine that all newborns are screened for congenital heart disease, they have encountered challenges—and developed important solutions,” said Dr. Martin. “These recommendations distill the learnings from a range of providers and stakeholders, to facilitate the process of making CCHD screening the ‘norm’ for newborns nationwide. With widespread earlier detection of serious heart problems, we can save many more babies’ lives and improve their long-term outcomes.”

To develop the recommendations, a workgroup of experts and stakeholders gathered in early 2012 to discuss challenges and areas of focus in implementing CCHD newborn screening. The group identified six major challenge areas:  Selection of screening equipment, standards for reporting screening outcomes, training for healthcare providers and education for families, future research priorities, payment  issues (for screening, follow-up diagnostic testing and public health oversight), and advocacy needs to facilitate effective, comprehensive screening. The published recommendations offer strategies for each area.

Elizabeth Bradshaw Mikula, MSN, RN, CPN, Coordinator for the Congenital Heart Disease Screening Program at Children’s National, was also an author of the recommendations. Mikula said, “In our work with other hospitals to help them implement CCHD screening in their nurseries, we see certain patterns in the challenges that arise. These recommendations address those key challenges and offer a roadmap to smooth the way toward making CCHD screening a standard practice.”

The authors conclude, “Addressing the challenges and acknowledging the opportunities for further work provides an opportunity to strengthen screening and newborn care networks in ways that should benefit children born with CCHD.”

Dr. Martin, Co-Director of the Children’s National Heart Institute at Children’s National Medical Center and an acknowledged expert in the area of pediatric echocardiography and fetal cardiology. He is a Professor of Pediatrics at the George Washington University School of Medicine and Health Sciences, a fellow of the American Academy of Pediatrics and the American College of Cardiology, and a member of the Society for Pediatric Research and the American Heart Association’s Council on Cardiovascular Disease in the Young. He has authored and contributed to more than 100 publications on pediatric cardiology.

Mikula helps other hospitals implement pulse oximetry screening in their nurseries for serious congenital heart disease. She also is responsible for coordinating research efforts surrounding the use of pulse ox screening for CCHD in the newborn nursery. She has presented many times and is the author of a number of publications on this topic.

The Congenital Heart Disease Screening team at Children’s National has been instrumental in advocating the use of CCHD screening as a standard of care for newborns. Some babies born with serious congenital heart disease appear normal and healthy at birth, with serious complications occurring after the baby goes home, leading to considerable risk to the baby’s life, growth and development.