18th ANNUAL EARLY HEARING DETECTION & INTERVENTION MEETING
March 3-5, 2019 • Chicago, IL

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  |  QI: Involving the Primary Care Provider in Improving Rescreen Rates

QI: Involving the Primary Care Provider in Improving Rescreen Rates

EHDI best practice guidelines state that infants should complete the newborn hearing screening (NHS) process by one month of age. In North Carolina, NHS is a two-stage process. Infants who do not pass the inpatient screen are referred for a follow-up outpatient rescreen, unless a direct referral for diagnostic evaluation is indicated due to high risk. In 2015, 2,577 (89%) infants who referred for a rescreen completed one. Of those rescreened, 611 infants (23.7%) did not complete the rescreen by one month of age. Also, 307 infants never received the required rescreen. Based on these findings, the NC-EHDI State Quality Improvement (QI) team initiated a QI test of change in 2016 aimed at improving rescreen rates. Baseline data (random sample of 25 infants) showed that 33% of infants that did not pass the inpatient screen were rescreened by one month of age and 45% never received an outpatient rescreen. If an infant did not pass the inpatient hearing screen, the Follow-up Coordinator called the primary care provider before the infant’s two-week appointment to notify them that the infant needed a rescreen by one month of age and encouraged the provider to talk with the family about the importance of having the rescreen and making sure the family had an appointment. The Follow-up Coordinator provided information on where to have the infant rescreened, if needed. After three Plan-Do-Study-Act (PDSA) cycles, the percentage of infants rescreened by one month of age increased to 80%. This procedural change also reduced the percentage of babies lost to follow-up at the rescreen to 5%. Based on the data findings, the new procedure was spread statewide in 2017. This presentation will examine the QI test of change including the aim statement, the PDSA cycles, data collected, lessons learned and next steps.

  • Participants will understand the newborn hearing screening process and tracking procedure in North Carolina
  • Participants will be able to describe PDSA testing methodology.
  • Participants will be able to describe the role of PCP in improving rescreen rates

Presentation:
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Transcripts:
CART transcripts are NOT YET available, but will be posted shortly after the conference


Presenters/Authors

Jude Williams (), NC Division of Public Health, Early Hearing Detection and Intervention Program, jude.williams@dhhs.nc.gov;
Jude has worked with the NC-EHDI Program for 8.5 years. Jude has her BS in Biology and MPH in Health Behavior/Health Education.

ASHA DISCLOSURE:

Financial - No relevant financial relationship exist.

Nonfinancial - No relevant nonfinancial relationship exist.


Shelia Sutton (), NC Division of Public Health, Shelia.Sutton@dhhs.nc.gov;
Shelia graduated from Liberty University in Lynchburg, Virginia with a Bachelor’s Degree in Business Management and a minor in Christian Counseling in May, 2012. Shelia also received a Master’s Degree in Religion with a concentration in Pastoral Counseling in December, 2015. She has worked for the State of North Carolina for 10 years with the Children and Youth Branch, Genetics and Newborn Screening Unit. For the past two years, Shelia has been the EHDI Follow-up Coordinator whereby her main duty is to make contact with Primary Care Providers to assist and educate them on the importance of making sure infants are making and keeping their rescreen appointments by 1 month of age.

ASHA DISCLOSURE:

Financial -

Nonfinancial -


Marcia Fort (), NC DHHS, marcia.fort@dhhs.nc.gov;
Dr. Fort is the Genetics and Newborn Screening Unit Manager in the Children and Youth Branch of the North Carolina Division of Public Health and serves as the NC EHDI Coordinator. She has worked with the NC EHDI program since 2002. Dr. Fort has 30 years of experience as a pediatric audiologist in hospital, private practice, ENT office and public school settings.

ASHA DISCLOSURE:

Financial - No relevant financial relationship exist.

Nonfinancial - No relevant nonfinancial relationship exist.