Incorporation of pulse oximetry to the assessment of the newborn infant can enhance detection of critical congenital heart disease (CCHD). Recently, the Secretary of Health and Human Services (HHS) recommended that screening for CCHD be added to the uniform screening panel. The American Academy of Pediatrics (AAP) has been a strong advocate of early detection of CCHD and fully supports the decision of the Secretary of HHS. The AAP has published strategies for the implementation of pulse oximetry screening, which addressed critical issues such as necessary equipment, personnel, and training, and also provided specific recommendations for assessment of saturation by using pulse oximetry as well as appropriate management of a positive screening result. The AAP is committed to the safe and effective implementation of pulse oximetry screening and is working with other advocacy groups and governmental agencies to promote pulse oximetry and to support widespread surveillance for CCHD. Going forward, AAP chapters will partner with state health departments to implement the new screening strategy for CCHD and will work to ensure that there is an adequate system for referral for echocardiographic/pediatric cardiac evaluation after a positive screening result. It is imperative that AAP members engage their respective policy makers in adopting and funding the recommendations made by the Secretary of HHS.

ABSTRACT. Pediatric cardiovascular centers should aim to provide high-quality therapeutic outcomes for infants and children with congenital and acquired heart diseases. This policy statement describes critical elements and organizational features of centers in which high-quality outcomes have the greatest likelihood of occurring. Center elements include noninvasive diagnostic modalities, cardiac catheterization, cardiovascular surgery, and cardiovascular intensive care. These elements should be organizationally united in centers in which pediatric cardiac physician specialists and specialized pediatric staff work together to achieve and surpass existing quality-of-care benchmarks.

ABSTRACT. It is the intent of this statement to inform pediatric providers on the appropriate use of echocardiography. Although on-site consultation may be impossible, methods should be established to ensure timely review of echocardiograms by a pediatric cardiologist. With advances in data transmission, echocardiography information can be exchanged, in some cases eliminating the need for a costly patient transfer. By cooperating through training, education, and referral, complete and cost-effective echocardiographic services can be provided to all children.