What do you mean you are declining?Gaby Kavanagh, Victorian Infant Hearing Screening Program

19th June 2015

• Determine decline rate• Analyse case notes• Identify trends• Inform program changes

Analysis of declines from 2011 - 2014

What is decline?VIHSP screen #1

Pass result in both ears Refer result in 1 or both ears

VIHSP screen #2

Pass result in both ears Refer result in 1 or both ears

Referral to Audiology & Early Support Services

Informed choice

CONSENT DECLINE

Sufficient information to make choice

Monitoring

• VIHSP expects and monitors declines

Decline Key Performance Indicator< 1% of eligible babies

Jan 2011 – Dec 2014

0

5

10

15

20

25

30

Jan‐11 Feb

Mar

April

May Jun Jul

Aug

Sept Oct

Nov Dec

Jan‐12 Feb

Mar

April

May Jun Jul

Aug

Sept Oct

Nov Dec

Jan‐13 Feb

Mar

April

May Jun Jul

Aug

Sept Oct

Nov Dec

Jan‐14 Feb

Mar

April

May Jun Jul

Aug

Sept Oct

Nov Dec

Rollout Complete

Eligible Screened Decline Decline Rate

2011 71,290 70,572 239 0.33%

2012 77,048 76,104 195 0.25%

2013 77,083 76,102 149 0.19%

2014 78,173 77,246 141 0.19%

VIHSP decline rate 2011-2014

729

Where? Who? Why?

Where?

outpatient decline

inpatient decline

Seasonal influences?

0

20

40

60Jan

Feb

Mar

Apr

May

Jun

Jul

Aug

Sep

Oct

Nov

Dec

outpatientin patient

Maybe not

0

20

40

60Jan

Feb

Mar

Apr

May

Jun

Jul

Aug

Sep

Oct

Nov

Dec

Jan

Feb

Mar

Apr

May

Jun

Jul

Aug

Sep

Oct

Nov

Dec

Screening not commenced

AABR1 Complete

AABR2 Complete

655 62 12

Location in Pathway

Where? Who? Why?• Further questions…

– Inpatients - effective use of time within the postnatal setting

– Outpatients - communication tools– Mobile/drop in centres. Home visits. – My New Baby Organiser app

Where? Who? Why?

Where? Who? Why?

Where? Who? Why?

• Further questions– Non English Speaking Background – analysis

of case notes and LOTE fields inconclusive

Where? Who? Why?

Where? Who? Why?

0

5

10

15

20

25

1/2011 2/2011 3/2011 4/2011 1/2012 2/2012 3/2012 4/2012 1/2013 2/2013 3/2013 4/2013 1/2014 2/2014 3/2014 4/2014

No Case Notes 2011 ‐14

Where? Who? Why?• Parental experience• Refuse all medical intervention• Logistical difficulties• Distrust equipment• Older children didn’t have a hearing screen• Older children have a hearing loss

0

5

10

15

20

25

30

Jan‐11 Feb

Mar

April

May Jun Jul

Aug

Sept Oct

Nov Dec

Jan‐12 Feb

Mar

April

May Jun Jul

Aug

Sept Oct

Nov Dec

Jan‐13 Feb

Mar

April

May Jun Jul

Aug

Sept Oct

Nov Dec

Jan‐14 Feb

Mar

April

May Jun Jul

Aug

Sept Oct

Nov Dec

?

gaby.kavanagh@rch.org.auSenior Project Officer, VIHSP

Images: shutterstock, visit Victoria, the fourth revolution