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NBS staff should use this checklist to make sure that all bases are covered before moving forward\u0026nbsp;with implementing\u0026nbsp;expanded operations with the NBS lab, follow-up, and courier. However,\u0026nbsp;given the variation in newborn screening (NBS) programmatic and state legislative processes, not \u003Cem\u003Eall\u003C\/em\u003E items will need to be completed by each state, but instead, this is a list of considerations to help your program anticipate challenges and prepare for the expansion of services and operating hours.\u003C\/p\u003E\u003Cblockquote\u003E\u003Cp\u003ECheckout\u0026nbsp;the 2012 Laboratory Efficiency Initiative, \u003Ca href=\u0022https:\/\/www.aphl.org\/MRC\/Documents\/LEI_2012May_PHL-Service-Changes-Guide.pdf\u0022\u003E\u003Cem\u003EA Practical Guide to Assessing and Planning Implementation of Public Health Laboratory Service Changes\u003C\/em\u003E\u003C\/a\u003E.\u0026nbsp;\u003C\/p\u003E\u003C\/blockquote\u003E \u003C\/div\u003E\n      \n      \n      \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003Cdiv class=\u0022toolkit-section\u0022\u003E  \u003Cdiv class=\u0022paragraph paragraph--type--text paragraph--view-mode--default\u0022\u003E\n          \n            \u003Cdiv class=\u0022field field--name-field-body field--type-text-long\u0022\u003E \u003Ch2\u003EWeekend \u0026amp; Holiday Program Logistics\u003C\/h2\u003E\u003Cul\u003E\u003Cli\u003EWork with the state Health Commissioner, follow-up staff, specialists, and the newborn screening advisory committee to determine which disorders to test and report out on weekends\/holidays. Develop a protocol for your weekend\/holiday notification strategy.\u003C\/li\u003E\u003Cli\u003EIdentify and procure equipment for efficient weekend\/holiday screening (i.e. does your lab have appropriate backup instrumentation in the event of a failure during weekend\/holiday if there is no vendor support?)\u003C\/li\u003E\u003Cli\u003EAssess need for data entry staff on weekend\/holidays.\u003C\/li\u003E\u003Cli\u003EAssess need for contracting referral lab on weekends\/holidays and which assays will be tested (i.e. all, molecular only, MS\/MS, etc.). Procure any necessary contracts, including courier contract to get specimens from state NBS lab to referral lab on weekends\/holidays.\u003C\/li\u003E\u003Cli\u003EIf testing is done in-house, develop an adjusted laboratory workflow to accommodate weekend\/holiday screening.\u003C\/li\u003E\u003Cli\u003EProcure vendor contracts for weekend\/holiday Laboratory Information Management System (LIMS) and instrument support.\u003C\/li\u003E\u003Cli\u003EProcure agency Information Technology (IT) support for weekends\/holidays (i.e. on-call support).\u003C\/li\u003E\u003Cli\u003EEnsure lab staff has remote access to instruments and LIMS in order to evaluate results and communicate out-of-range values to follow-up staff.\u003C\/li\u003E\u003Cli\u003EEnsure follow-up staff has access to remote technology to receive and report out results to medical providers.\u003C\/li\u003E\u003C\/ul\u003E \u003C\/div\u003E\n      \n      \n      \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003Cdiv class=\u0022toolkit-section\u0022\u003E  \u003Cdiv class=\u0022paragraph paragraph--type--text paragraph--view-mode--default\u0022\u003E\n          \n            \u003Cdiv class=\u0022field field--name-field-body field--type-text-long\u0022\u003E \u003Ch2\u003EWeekend \u0026amp; Holiday Staffing\u003C\/h2\u003E\u003Cul\u003E\u003Cli\u003EBe aware of your state\u2019s union or civil service rules for changing work schedules to include weekends\/holidays and determine appropriate compensation (i.e. job classification changes, overtime, on-call fee, flex or comp day, part of the regular salary, etc.).\u003C\/li\u003E\u003Cli\u003EIdentify a staff \u201cchampion\u201d to help gain buy-in from other staff for weekend\/holiday operations.\u003C\/li\u003E\u003Cli\u003EIncorporate expectations for weekend\/holiday shifts for incoming staff via job descriptions, interview process, etc.\u003C\/li\u003E\u003Cli\u003EEnsure adequate staffing, including correct expertise\/management for weekend\/holiday shifts and develop staffing plan (i.e. hire new part-time or full-time staff, recruit staff from other sections of the public health lab to take weekend\/holiday shift, etc.).\u003C\/li\u003E\u003Cli\u003EDevelop staff scheduling system for weekend\/holiday shifts (rotation, volunteer sign-up, etc.).\u003C\/li\u003E\u003Cli\u003ECross-train laboratory staff on different equipment\/benches.\u003C\/li\u003E\u003Cli\u003EIf follow-up does not operate on weekends and\/or holidays, cross-train laboratory staff on necessary follow-up protocols for calling out urgent results on weekends\/holidays to specialists and\/or genetic centers.\u003C\/li\u003E\u003C\/ul\u003E \u003C\/div\u003E\n      \n      \n      \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003Cdiv class=\u0022toolkit-section\u0022\u003E  \u003Cdiv class=\u0022paragraph paragraph--type--text paragraph--view-mode--default\u0022\u003E\n          \n            \u003Cdiv class=\u0022field field--name-field-body field--type-text-long\u0022\u003E \u003Ch2\u003ESpecimen Delivery on Weekends \u0026amp; Holidays\u003C\/h2\u003E\u003Cul\u003E\u003Cli\u003ENegotiate contract with the courier for specimen pickup and delivery to the laboratory on weekend\/holidays.\u0026nbsp;\u003C\/li\u003E\u003Cli\u003EIdentify other means to receive specimens on weekends\/holidays, such as drop-off location at local\/county health department, shared courier, etc.\u003C\/li\u003E\u003Cli\u003EEnsure that the courier is aware of different pickup locations at the birthing facilities and\/or drop-off location at the lab if different than rest of regular work week.\u003C\/li\u003E\u003Cli\u003EInform birthing facilities about weekend\/holiday pickup and times; consider performing workflow analysis for hospitals.\u003C\/li\u003E\u003Cli\u003EProvide education about the importance of newborn screening to the courier provider, as needed.\u003C\/li\u003E\u003Cli\u003EPilot test weekend\/holiday courier route with large birthing facilities and then expand to additional facilities.\u003C\/li\u003E\u003C\/ul\u003E\u003Cblockquote\u003E\u003Cp\u003ETo help hold your courier service accountable it is important to build in a formal monitoring process as part of the courier contract and include specific language on pick-up and delivery times and necessary recourse for any contract violations. The bidding process should also state-specific requirements, such as the delivery cutoff times by day.\u0026nbsp;It is important that NBS program staff are involved in the contract writing process to ensure that delivery needs are adequately specified. See \u003Ca href=\u0022https:\/\/www.michigan.gov\/documents\/localgov\/7700028_543710_7.pdf\u0022\u003EMichigan\u2019s Notice of Contract with STAT Courier\u003C\/a\u003E which can be used as an example to help your program create a comprehensive courier contract that will meet your state\u2019s needs.\u003C\/p\u003E\u003C\/blockquote\u003E \u003C\/div\u003E\n      \n      \n      \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003Cdiv class=\u0022toolkit-section\u0022\u003E  \u003Cdiv class=\u0022paragraph paragraph--type--text paragraph--view-mode--default\u0022\u003E\n          \n            \u003Cdiv class=\u0022field field--name-field-body field--type-text-long\u0022\u003E\u003Ch2\u003EApproval for Funding\u003C\/h2\u003E\n\n\u003Cul\u003E\n\t\u003Cli\u003EEstimate the cost of expanding program\/delivery services on weekends\/holidays, including but not limited to:\n\t\u003Cul\u003E\n\t\t\u003Cli\u003ECompensation for NBS laboratory staff to cover weekend and\/or holidays (overtime pay, flex days, other).\u003C\/li\u003E\n\t\t\u003Cli\u003ECompensation for NBS follow-up staff to cover weekend and\/or holidays (on-call, flex days, other).\u003C\/li\u003E\n\t\t\u003Cli\u003EVendor support for weekends\/holidays.\u003C\/li\u003E\n\t\t\u003Cli\u003EAgency IT support for weekend\/holidays.\u003C\/li\u003E\n\t\t\u003Cli\u003ECourier or other specimen delivery service for weekend\/holidays.\u003C\/li\u003E\n\t\t\u003Cli\u003EAdditional assays and other lab materials.\u003C\/li\u003E\n\t\u003C\/ul\u003E\n\t\u003C\/li\u003E\n\t\u003Cli\u003EDevelop a budget or fiscal note to support the expansion of NBS program operating hours, including laboratory and follow-up staffing, laboratory testing, information technology, etc. This may be done in conjunction with adding new disorders to the panel.\u003C\/li\u003E\n\t\u003Cli\u003EObtain approval by NBS Advisory Committee, or other authority, for the increase in funding, as needed.\u003C\/li\u003E\n\t\u003Cli\u003EObtain approval by the State Budget Authority, as needed.\u003C\/li\u003E\n\u003C\/ul\u003E\n\n\u003Cblockquote\u003E\n\u003Cp\u003ESee \u003Ca href=\u0022http:\/\/www.who.int\/choice\/toolkit\/cost_it\/en\/\u0022\u003ECostIT\u003C\/a\u003E, a WHO tool designed to record and analyze cost data.\u0026nbsp;\u003C\/p\u003E\n\u003C\/blockquote\u003E\n\u003C\/div\u003E\n      \n      \n      \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003Cdiv class=\u0022toolkit-section\u0022\u003E  \u003Cdiv class=\u0022paragraph paragraph--type--text paragraph--view-mode--default\u0022\u003E\n          \n            \u003Cdiv class=\u0022field field--name-field-body field--type-text-long\u0022\u003E \u003Ch2\u003EAuthority for Expanded Newborn Screening Program Operating Hours\u003C\/h2\u003E\u003Cul\u003E\u003Cli\u003EObtain approval from the NBS Advisory Committee, as needed.\u003C\/li\u003E\u003Cli\u003EObtain approval from the Board of Health, Health Commissioner, Title V Coordinator, etc., as needed.\u003C\/li\u003E\u003Cli\u003EObtain regulatory rule changes to increase NBS fee, if necessary.\u003C\/li\u003E\u003Cli\u003EObtain mandate\/approval to start screening on weekends\/holidays, if necessary.\u003C\/li\u003E\u003C\/ul\u003E \u003C\/div\u003E\n      \n      \n      \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003Cdiv class=\u0022toolkit-section\u0022\u003E  \u003Cdiv class=\u0022paragraph paragraph--type--text paragraph--view-mode--default\u0022\u003E\n          \n      \n      \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\n\n\n\u003C\/article\u003E\n\u003C\/div\u003E\n              \u003C\/div\u003E\n        \u003C\/div\u003E\n\n    \n  \n    \n  \n\u003C\/div\u003E\n\u003C\/div\u003E","settings":null},{"command":"scrollBottomCommand","nodeSelector":".js-node-contain-tab","scrollToSelector":".custom-tab-nav","message":"Provides an AJAX command for scrolling to the bottom of an element"},{"command":"insert","method":"replaceWith","selector":"#toolkit-additional-block-wrapper","data":"\u003Cdiv id=\u0022toolkit-additional-block-wrapper\u0022\u003E\u003Cdiv class=\u0022js-view-dom-id-8a99cbadec7d8a344943915ff909b6449e58c9fbbb93576f699acdf9607b67e8\u0022\u003E\n  \n  \n  \n\n  \n  \n  \n\n  \u003Cdiv class=\u0022views-view-grid horizontal cols-4000 clearfix\u0022\u003E\n              \u003Cdiv\u003E\n                  \u003Cdiv\u003E\n\u003Carticle data-history-node-id=\u00221994\u0022 class=\u0022node node--type-section node--view-mode-teaser toolkit-sidebar\u0022\u003E\n  \n  \n\n  \n      \u003Cdiv class=\u0022field field--name-field-case-studies field--type-entity-reference\u0022\u003E\n              \u003Cdiv\u003E\n\u003Carticle data-history-node-id=\u00221995\u0022 class=\u0022node node-card node--type-case-study node--view-mode-teaser\u0022\u003E\n  \n  \n  \u003Cdiv class=\u0022card-case-study\u0022\u003E\n    \u003Cdiv class=\u0022case-study-primary_type icon-case-study\u0022\u003E\n      \u003Ch3\u003ECase Study\u003C\/h3\u003E\n    \u003C\/div\u003E\n    \u003Cdiv class=\u0022h3 sub-title\u0022\u003ENew Jersey\u003C\/div\u003E\n    \n            \u003Cdiv class=\u0022field field--name-body field--type-text-with-summary\u0022\u003E  \u003Ch4\u003E\u003Cstrong\u003EWorkflow\u003C\/strong\u003E\u003C\/h4\u003E\n\n\u003Cp\u003EAt the beginning of Saturday laboratory operations, the department wanted to improve newborn screening (NBS) timeliness using minimal resources. At first, only Tandem Mass...\u003C\/p\u003E\n\n\u003C\/div\u003E\n      \n  \u003C\/div\u003E\n  \u003Ca href=\u0022\/resources\/toolkits\/timeliness-toolkit-expanding-newborn-screening-services\/new-jersey\u0022 class=\u0022link link-text mt-2\u0022\u003ERead Full Case Study\u003C\/a\u003E\n\u003C\/article\u003E\n\n\u003C\/div\u003E\n              \u003Cdiv\u003E\n\u003Carticle data-history-node-id=\u00221996\u0022 class=\u0022node node-card node--type-case-study node--view-mode-teaser\u0022\u003E\n  \n  \n  \u003Cdiv class=\u0022card-case-study\u0022\u003E\n    \u003Cdiv class=\u0022case-study-primary_type icon-case-study\u0022\u003E\n      \u003Ch3\u003ECase Study\u003C\/h3\u003E\n    \u003C\/div\u003E\n    \u003Cdiv class=\u0022h3 sub-title\u0022\u003ETexas\u003C\/div\u003E\n    \n            \u003Cdiv class=\u0022field field--name-body field--type-text-with-summary\u0022\u003E  \u003Ch4\u003E\u003Cstrong\u003EStaffing\u003C\/strong\u003E\u003C\/h4\u003E\n\n\u003Cp\u003EThe Texas Newborn Screening Laboratory changed from five to six-day operations in 2007. Five analytical staff were added to accommodate this change, resulting in a current total of...\u003C\/p\u003E\n\n\u003C\/div\u003E\n      \n  \u003C\/div\u003E\n  \u003Ca href=\u0022\/resources\/toolkits\/timeliness-toolkit-expanding-newborn-screening-services\/texas\u0022 class=\u0022link link-text mt-2\u0022\u003ERead Full Case Study\u003C\/a\u003E\n\u003C\/article\u003E\n\n\u003C\/div\u003E\n          \u003C\/div\u003E\n  \n      \u003Cdiv class=\u0022shadow-card--sidebar\u0022\u003E\n      \u003Cdiv id=\u0022block-block-section-related-resources\u0022\u003E\n  \n  \n        \u003Cdiv id=\u0022toolkit-related-resources-wrapper\u0022\u003E\u003C\/div\u003E\n  \u003C\/div\u003E\n\n    \u003C\/div\u003E\n  \u003C\/article\u003E\n\u003C\/div\u003E\n              \u003C\/div\u003E\n        \u003C\/div\u003E\n\n    \n  \n    \n  \n\u003C\/div\u003E\n\u003C\/div\u003E","settings":null},{"command":"insert","method":"replaceWith","selector":"#toolkit-related-resources-wrapper","data":"\u003Cdiv id=\u0022toolkit-related-resources-wrapper\u0022\u003E\u003Cdiv class=\u0022toolkit-related-resources js-view-dom-id-df27de7bf8dd2ecb8e763883af218aa7912c6186cb1407eed2332592ae275dfb\u0022\u003E\n  \n  \n  \n\n      \u003Ch2 class=\u0022block-title\u0022\u003ERelevant Resource\u003C\/h2\u003E\n  \n  \n  \n\n  \u003Cdiv class=\u0022views-view-grid horizontal cols-4000 clearfix\u0022\u003E\n              \u003Cdiv\u003E\n                  \u003Cdiv\u003E\u003Carticle class=\u0022node node--view-mode-related node-related\u0022\u003E\n  \u003Ca href=\u0022\/resource-library\/newborn-screening-nbs-fiscal-planning-and-resource-allocation\u0022 class=\u0022h3 icon-educational-tools node-related\u0022\u003ENewborn Screening (NBS) Fiscal Planning and Resource Allocation\u003C\/a\u003E\n\u003C\/article\u003E\u003C\/div\u003E\n                  \u003Cdiv\u003E\u003Carticle class=\u0022node node--view-mode-related node-related\u0022\u003E\n  \u003Ca href=\u0022\/resources\/webinars-events\/increasing-laboratory-operations-mo-and-tn\u0022 class=\u0022h3 icon-webinars node-related\u0022\u003EIncreasing Laboratory Operations in MO and TN\u003C\/a\u003E\n\u003C\/article\u003E\u003C\/div\u003E\n              \u003C\/div\u003E\n        \u003C\/div\u003E\n\n    \u003Cdiv class=\u0022views-element-container\u0022\u003E\u003Cdiv class=\u0022js-view-dom-id-d5e07bd81be652661306d002514647a42f84aa9693100ea7235b047601c7bcda\u0022\u003E\n  \n  \n  \n\n  \n  \n  \n\n  \u003Cdiv class=\u0022views-view-grid horizontal cols-4000 clearfix\u0022\u003E\n              \u003Cdiv\u003E\n                  \u003Cdiv\u003E\u003Carticle class=\u0022node node--view-mode-related node-related\u0022\u003E\n  \u003Ca href=\u0022\/toolkits\/timeliness-toolkit-expanding-newborn-screening-services\/overview-nbs-weekend-holiday\u0022 class=\u0022h3 icon-toolkit node-related\u0022\u003EOverview of NBS Weekend \u0026amp; Holiday Operations\u003C\/a\u003E\n\u003C\/article\u003E\u003C\/div\u003E\n                  \u003Cdiv\u003E\u003Carticle class=\u0022node node--view-mode-related node-related\u0022\u003E\n  \u003Ca href=\u0022\/resources\/webinars-events\/informational-newborn-screening-nbs-webinar-notice-proposed-rulemaking\u0022 class=\u0022h3 icon-webinars node-related\u0022\u003EInformational Newborn Screening (NBS) Webinar on Notice of Proposed Rulemaking: The Common Rule \u003C\/a\u003E\n\u003C\/article\u003E\u003C\/div\u003E\n              \u003C\/div\u003E\n        \u003C\/div\u003E\n\n    \n  \n    \n  \n\u003C\/div\u003E\n\u003C\/div\u003E\n\n  \n      \u003Cfooter\u003E\n      \u003Cspan class=\u0022link link-button js-link-series\u0022\u003EShow more\u003C\/span\u003E\n    \u003C\/footer\u003E\n    \n  \n\u003C\/div\u003E\n\u003C\/div\u003E","settings":null}]