Quality monitoring for early hearing detection and intervention programs to optimize performance

Finitzo, Terese; Grosse, Scott D.

doi:10.1002/mrdd.10062

Cited by 14 publications

(12 citation statements)

References 12 publications

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“…Similarly a pilot infant hearing screening program at a public health care immunization clinic reported an even higher initial referral rate of 14% but only evaluated the initial 5 months of implementation [27]. Suboptimal referral rates reported by the remaining 20% of universal programs in this survey may have been due to factors such as poor data management or quality control, recently commenced programs, suboptimal screening technologies (such as AOAE implemented in NICUs) and test environment or procedural issues [16,[32][33].…”

Section: Referral and Follow-up Performance And Protocolsmentioning

confidence: 97%

“…Also, a suboptimal follow-up return rate of 60% was reported for a pilot screening program at an immunization clinic in South Africa [27]. Since hearing screening is not yet mandated or regulated in South Africa there is a lack of program quality control and no systematic protocol for tracking parents and their babies to attend follow-up appointments which may contribute to poor follow-up compliance [32][33][34]. In addition, insufficient support from other key health professionals such as family physicians and pediatricians may discourage parents from prioritizing hearing screening follow-up [16,34,37].…”

Section: Referral and Follow-up Performance And Protocolsmentioning

confidence: 99%

“…Successful screening programs rely on data management systems to ensure the process of screening through to diagnosis and intervention is efficient with adequate quality control [12,[32][33][34]. Screening information should be managed by integrated information systems to provide data for service development and to monitor infants at risk for developing late onset or progressive hearing loss [12,[32][33][34].…”

Section: Data Management Practicesmentioning

confidence: 99%

“…Screening information should be managed by integrated information systems to provide data for service development and to monitor infants at risk for developing late onset or progressive hearing loss [12,[32][33][34]. Less than a third (23/77) of programs in the private health care sector used an electronic database.…”

Section: Data Management Practicesmentioning

confidence: 99%

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Early detection of infant hearing loss in the private health care sector of South Africa

Meyer

Swanepoel

Roux

et al. 2012

International Journal of Pediatric Otorhinolaryngology

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Objective: A national survey of early hearing detection services was undertaken to describe the demographics, protocols and performance of early hearing detection, referral, follow-up and data management practices in the private health care sector of South Africa.Methods: All private hospitals with obstetric units (n=166) in South Africa were surveyed telephonically. This data was incorporated with data collected from self-administered questionnaires subsequently distributed nationally to audiology private practices providing hearing screening at the respective hospitals reporting hearing screening services (n=87). Data was analyzed descriptively to yield national percentages and frequency distributions and possible statistical associations between variables were explored.Results: Newborn hearing screening was available in 53% of private health care obstetric units in South Africa of which only 14% provided universal screening. Most (81%) of the healthy baby screening programs used only otoacoustic emission screening. Auditory brainstem response screening was employed by 24% of neonatal intensive care unit screening programs with only 16% repeating auditory brainstem response screening during the follow-up screen. Consequently 84% of neonatal intensive care unit hearing screening programs will not identify auditory neuropathy. A referral rate of less than 5% for diagnostic assessments was reported by 80% of universal programs. Follow-up return rates were reported to exceed 70% by only 28% of programs. Using multiple methods of reminding parents did not significantly increase reported follow-up return rates. Data management was mainly paper based with only 10% of programs using an electronic database primarily to manage screening data. Conclusions:A shortage of programs and suboptimal and variable protocols for early hearing detection, follow-up and data management in existing programs mean the majority of babies with hearing loss in the South African private health care sector will not be identified early. Newborn hearing screening must be integrated with hospital-based birthing services, ideally with centralized data management and quality control.

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Section: Referral and Follow-up Performance And Protocolsmentioning

confidence: 97%

Section: Referral and Follow-up Performance And Protocolsmentioning

confidence: 99%

Section: Data Management Practicesmentioning

confidence: 99%

Section: Data Management Practicesmentioning

confidence: 99%

See 2 more Smart Citations

Early detection of infant hearing loss in the private health care sector of South Africa

Meyer

Swanepoel

Roux

et al. 2012

International Journal of Pediatric Otorhinolaryngology

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“…Diagnosis with early intervention can effectively contribute to improve the child's development when followed by a proper rehabilitation program 11 . In order to achieve a quality monitoring of the neonatal hearing screening, it is necessary to have qualified professionals, control and calibration of the procedures, a database system, planning and evaluation of the procedures 12 . Considering the lack of a neonatal auditory screening program in the city of Porto Velho, Limiar Clinic implemented the first NHS program in August of 2002, at the Dr. Ary Pinheiro Base Hospital.…”

Section: Introductionmentioning

confidence: 99%

Caracterização da triagem auditiva neonatal da Clínica Limiar em Porto Velho - Rondônia

Botelho¹,

Silva²,

Arruda³

et al. 2010

Braz. j. otorhinolaryngol. (Impr.)

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Wi th the universal hearing screening we can prevent auditory disorders in children. Aim:To characterize the program of neonatal auditory screening into a population of neonates.Materials and Methods: longitudinal cohort study. We surveyed the clinic's database on neonatal auditory screening in the city of Porto Velho, Rondônia.Results: Among the 6,889 newborns in the database, 5,700 (82.7%) passed and 1,189 (17.3%) failed the first screening. Of the group which failed 900 (75.7 %) returned for retesting. Among these, 15 (0.22 %) newborns had hearing loss confirmed. The most prevalent was neural hearing loss with 46.7% confirmed cases; they had hyperbilirubinemia as the most prevalent risk factor.Conclusion: hyperbilirubinemia was the most prevalent risk factor found in the group of hearing impaired children. The prevalence of hearing loss was of 2 in 1,000 newborns. It is important to highlight the relevant association between neural hearing loss caused by hyperbilirubinemia and sensorineural hearing loss of unknown causes. Braz J Otorhinolaryngol. 2010;76(5):605-10. ORIGINAL ARTICLE

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Newborn hearing screening in a South African private health care hospital

Swanepoel¹,

Ebrahim²,

A³

et al. 2007

International Journal of Pediatric Otorhinolaryngology

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Summary ObjectiveEarly Hearing Detection and Intervention (EHDI) programs are being established as part of the public health systems in increasing numbers of countries. In developing countries, however, little progress has been made towards implementing NHS programs and South Africa's public and private health care sectors is no exception.The current study presents the first report on a hospital-based UNHS program conducted in the South African private health care sector to provide preliminary results towards advocating for and guiding future programs. MethodsA retrospective study of a UNHS program at a private hospital in urban Gauteng, South Africa over a 4 year period of time was performed. Screening was conducted with Transient Evoked Otoacoustic Emissions (TEOAE) with a rescreen recommended within 6 weeks if referred. Diagnostic audiological assessments were performed on those infants referring the rescreen. The discharge screening costs were subsidized through the hospital birthing package for the first 22 months of the program. openUP (September 2007) ResultsSix thousand two hundred and forty-one newborns were screened from 13,799 hospital births during the first 4 years. Ninety-four percent of these infants were from the well-baby nurseries. During the initial 22 months, whilst the service was subsidized as part of the hospital birthing package, coverage of 75% was attained compared to 20% during the subsequent 26 months. The overall referral rate for the screening program across the 4 years was 11.1% but referral rates decreased by between 2 and 4% for each year of program existence with a 5% rate in year 4. Only 32% of the rescreens were completed at the hospital and no data was available for the remaining infants because parents were provided a choice of follow up centers.Referral for a diagnostic assessment after the rescreens at the hospital was predictive of sensorineural hearing loss in one-third of cases and the estimated prevalence was 3 in every 1000. ConclusionsScreening coverage in the current study was not adequately high and can be attributed to insufficient parental knowledge to make an informed decision. Improvements in program efficiency over time also suggest that pilot programs must be monitored over sufficiently long periods of time to allow observations of optimal efficiency. Initial referral rates and prevalence data indicate a large hearing loss burden and the capacity to implement increasingly efficient programs in South Africa.

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Quality monitoring for early hearing detection and intervention programs to optimize performance

Cited by 14 publications

References 12 publications

Early detection of infant hearing loss in the private health care sector of South Africa

Early detection of infant hearing loss in the private health care sector of South Africa

Caracterização da triagem auditiva neonatal da Clínica Limiar em Porto Velho - Rondônia

Newborn hearing screening in a South African private health care hospital

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