Action Kit Gives Audiologists New Resources for Follow-Up Care
Posted November 09, 2016 by Josh Grant
|QI may hold the key for reducing loss to follow-up for audiologists.
Not all newborns who require hearing intervention services receive them. According to the Centers for Disease Control and Prevention (CDC), 32.1 percent of children who were diagnosed with hearing loss in 2013 were lost to follow-up
and 24.4 of children were not enrolled in early intervention services
While there are many barriers to follow-up and non-enrollment, including language barriers with non-English speaking parents and families who weren’t aware their child needed additional screenings, audiologists can reduce these challenges to ensure that children are receiving necessary and timely services. The opportunity to improve hearing services starts with the systems providers use to engage patients, which is what Improving Follow-Up After Newborn Hearing Screening: An Action Kit for Audiologists
seeks to address.
Funded by the National Center for Hearing Assessment and Management (NCHAM), the online action kit includes resources created by early hearing detection and intervention (EHDI) programs from 49 states and 3 territories. These resources were developed and tested as part of the quality improvement (QI
) work undertaken by these programs during the course of five learning collaboratives
conducted by NICHQ between 2013 and 2016.
“Over the course of our collaboratives with the EHDI teams, we focused on using QI principles to address internal and external barriers that hindered follow-up for children,” says Patricia Finnerty, MSc, an improvement advisor at NICHQ. “Compiling all of these resources in this new action kit allows audiologists to assess their processes, test and refine changes based on promising practices, and address specific issues preventing follow-up and intervention services for their patients.”
The first part of the action kit is an assessment which prompts audiologists to rate their internal processes on a four-point scale. The practices are then graded and put into four categories: pre-appointment activities, appointments, reporting results and next steps following diagnoses. Next, improvement strategies are recommended, along with potential measures to track their effectiveness.
Monitoring change and its impact is a key component of successful use of the action kit. As with all QI work, process measures highlight whether a change is an actual improvement or if it doesn’t achieve the desired outcome.
Fortunately, audiology practices can access other strategies through the action kit, if the improvement strategies they use don’t meet their performance measures. Because the resources and change ideas come from teams from across the United States, they account for myriad challenges and present unique solutions to both local and broad barriers.
For instance, Louisiana EHDI (LA EHDI) contributed examples of their faxback program, which was created during NICHQ’s Improved Hearing Screening and Intervention Services (IHSIS) collaborative. LA EHDI faxes forms to newborns’ primary-care physicians to see whether patients had been brought in for confirmation screenings. The provider is encouraged to contact the parents about the follow-up appointment, which has been found to generate a better response than if LA EHDI called the families.
“Alaska and two other states have been successful in adopting our faxback program, but it didn’t work for another,” says Jeanette Webb, LA EHDI’s follow-up coordinator. “The action kit will help organizations and audiologists find strategies have proven effective for resolving their challenges in other settings. And if the changes don’t produce the expected results, there are other options to test and adapt.”
The flexibility to try proven ideas and test their effectiveness are two of the hallmarks of successful QI initiatives. With this action kit, audiologists can learn from others and start finding new ways to ensure that their patients are receiving proper follow-up and care.