17th ANNUAL EARLY HEARING DETECTION & INTERVENTION MEETING
March 18-20, 2018 • Denver, CO
3/20/2018 | 10:15 AM - 10:40 AM | Outcomes from COACHing: Implementation of a Statewide Audiologic Protocol | Capitol 7
Outcomes from COACHing: Implementation of a Statewide Audiologic Protocol
Over the past 4 years, audiology departments at Cincinnati Children’s Hospital and Nationwide Children’s Hospital have collaborated with the Ohio Department of Health to develop evidence-based protocols for diagnostic audiology following newborn hearing screening referrals. A working group was convened, known as “COACH”, or Coalition of Audiologists and Children’s Hospitals. The process was intensive and methodical, including several rounds of stakeholder meetings and peer input. The protocol was developed in 2015-16, peer-reviewed in 2016-17, and adopted by the Ohio Department of Health in early 2017. A three-day training workshop was held in Ohio in June, 2017, that included audiologists in Ohio and nationally. The workshop provided hands-on training on diagnostic and amplification best practices, and included real life cases and examples of successful implementation. Prior to developing the protocol, audiologists at Nationwide Children’s Hospital and Cincinnati Children’s Hospital had studied ways to complete full assessments with an aim to reduce loss to follow-up. Barriers to full diagnosis, such as inappropriate use of click stimuli, stopping the assessment if middle ear function was not normal, and rescheduling babies who didn’t sleep were addressed with specific interventions. Specific interventions that were trialed included always testing with toneburst stimuli, continuing the assessment despite abnormal tympanometry, using Kalman averaging methods to improve recordings in light sleep, implementing methods to encourage better sleep, and cross-checking with OAE results. These best practice interventions resulted in improvements in completion of full diagnostic evaluations, and loss to follow-up rates. Tips and tricks for implementing protocol improvements will be addressed to share knowledge about practice improvement and keys to success.
- List barriers to diagnosis and foloow-up
- List interventions that improve diagnosis and follow-up
- Describe the journey of quality improvement to actively engage clinicians
Presentation:
15805_7855LisaHunter.pdf
Handouts:
Handout is not Available
Transcripts:
15805_7855LisaHunter.docx
Presenters/Authors
Reena Kothari
(), Ohio Department of Health, Reena.Kothari@odh.ohio.gov;
Reena Kothari, Au.D. is currently a Public Health Audiology Consultant for The Ohio Department of Health in the Infant Hearing Program and the newborn hearing screening contact. Reena has spoken both nationally and statewide about Ohio’s EHDI program. She has developed many public awareness materials in several formats for the Ohio Department of Health’s Infant Hearing Program. Reena was the team lead for the National Initiative on Children’s Healthcare Quality (NICHQ) and is a member of several committees in Ohio. Her previous experience includes newborn hearing screening, clinical and dispensing services for adults and pediatrics. Reena has a strong background in Early Hearing Detection and Intervention (EHDI) and is interested in continuous quality improvement for successful outcomes for children identified with hearing loss and deafness.
ASHA DISCLOSURE:
Financial -
No relevant financial relationship exist.
Nonfinancial -
No relevant nonfinancial relationship exist.
Lisa Hunter
(), Cincinnati Children's Hospital, lisa.hunter@cchmc.org;
Lisa Hunter is Scientific Director of Audiology and Professor at Cincinnati Children's Hospital Medical Center and the University of Cincinnati. She collaborates on a number of funded studies including evaluating physiologic factors associated with risks for hearing loss and understanding mechanisms for improved follow-up with newborn hearing screening in high risk famlies. She is a faculty with the Leadership Education in Neurodevelopmental and related Disabilities at Cincinnati Children's Hospital Medical Center.
ASHA DISCLOSURE:
Financial -
No relevant financial relationship exist.
Nonfinancial -
No relevant nonfinancial relationship exist.
Wendy Steuerwald
(), Phoenix Children's Hospital, wsteuerwald@phoenixchildrens.com;
Wendy Steuerwald, AuD, is the Director of Audiology at Phoenix Children’s Hospital. She works with hospital leadership and audiologists to create an environment where exceptional patient care is the norm. This includes use of evidence based practice, process improvement initiatives, expansion of services offered, the addition of new locations, and hiring the best audiologists. Wendy’s overall focus is to improve the patient’s experience within audiology while providing evidence based care. Professional leadership includes committee work with the American Academy of Audiology, American Speech Language Hearing Association, and multiple state organizations. Wendy also has numerous presentations and publications. Local committee work includes participation in the interdisciplinary Stop CMV AZ partnership.
ASHA DISCLOSURE:
Financial -
No relevant financial relationship exist.
Nonfinancial -
No relevant nonfinancial relationship exist.
Gina Hounam
(), Nationwide Children's Hospital, gina.hounam@nationwidechildrens.org;
Gina Hounam is the program manager of Audiology at Nationwide Children's Hospital. Gina received a B.A. in Speech and Hearing Science at Ohio State University and received her M.A. and Ph.D. from the University of Cincinnati. Gina has been an audiologist for 15+ years and her professional interests include relationship-centered care, community outreach, UNHS and hearing aids.
ASHA DISCLOSURE:
Financial -
No relevant financial relationship exist.
Nonfinancial -
No relevant nonfinancial relationship exist.
Ursula Findlen
(), Nationwide Children's Hospital, ursula.findlen@nationwidechildrens.org;
Ursula M. Findlen, Ph.D., is the Director of Audiology Research in the Division of Clinical Therapies- Audiology Department at Nationwide Children’s Hospital and an Assistant Professor-Clinical at The Ohio State University College of Medicine, Department of Otolaryngology- Head and Neck Surgery. Dr. Findlen engages in clinical practice and research endeavors related to pediatric (re)habilitative audiology, particularly in regards to a multidisciplinary team approach to family-centered care. Her research interests include infant diagnostics and improving outcomes of children with hearing loss through systematic quality improvement and population health endeavors.
ASHA DISCLOSURE:
Financial -
No relevant financial relationship exist.
Nonfinancial -
No relevant nonfinancial relationship exist.
Kelly Baroch
(), Cincinnati Children's Hospital Medical Center, kelly.baroch@cchmc.org;
Kelly A. Baroch is a clinical audiologist with the Division of Audiology and the coordinator of the Inpatient Audiology and Infant Hearing and Screening Program, which she developed in 2003. She has given numerous state and national presentations on early identification and intervention of hearing loss in the medically complex population, auditory development in infants, and the effects of the NICU environment on sensory development. She provides clinical support on multiple research projects.
ASHA DISCLOSURE:
Financial -
No relevant financial relationship exist.
Nonfinancial -
No relevant nonfinancial relationship exist.