Table 2.

Needs identified in State Newborn Screening Program Site Reviews: Communication Outside the State Newborn Screening Program themes identified (Number of times reported in site review report, individual interview, and pre-site review forms).

Category	Sub-Theme
Birthing Facility Communication Needs (4/7 reports, 1/3 interviews, 1/7 pre-site review forms)
	Provide birthing center a report on poor quality specimens
	Inform birthing center when a specimen collected was out of range, and the number of newborns they identified through newborn screening.
	Communicate to whole hospital system rather than just one part
Communication between NBS program and specialists needs to be improved (5/7 reports, 1/3 interviews, 0/7 pre-site review forms)
	Report out-of-range results to specialists
	Educate clinicians on methods to test for conditions and why changes are made in testing procedures
	Communicate results more efficiently, including using of higher tech solution for reporting results
	Convene meetings between programs and specialists allowing video, phone, in person options for attendance
	Create culture to allow specialists to feel heard/valued
NBS program needs to work with specialists on refining cut-off values (5/7 reports, 0/3 interviews, 0/7 pre-site review forms)
Needs identified by clinical specialists (4/7 reports, 0/3 interviews, 0/7 pre-site review forms)
	Develop leadership in lab
	Update ACT sheets and FACT sheets
	Create system for project improvements to increase efficiency of implementation
	Develop age adjusted cut-offs