Evaluation of EHDI Programs ________________________ Terry Foust, Au.D., CCC-A/SLP Karen Muñoz,...
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Transcript of Evaluation of EHDI Programs ________________________ Terry Foust, Au.D., CCC-A/SLP Karen Muñoz,...
Evaluation of EHDI Evaluation of EHDI ProgramsPrograms
________________________________________________
Terry Foust, Au.D., CCC-A/SLPTerry Foust, Au.D., CCC-A/SLP
Karen Muñoz, Ph.D., CCC-AKaren Muñoz, Ph.D., CCC-A
Kathleen Watts, M.S.Kathleen Watts, M.S.National Center for Hearing Assessment & National Center for Hearing Assessment &
ManagementManagement
Utah State UniversityUtah State University
Why Evaluate?Why Evaluate?
AcountabilityAcountability Demonstrate program improvement Demonstrate program improvement
over timeover time Demonstrate evidence based practice Demonstrate evidence based practice Demonstrate attainment of program Demonstrate attainment of program
goals (1.3.6)goals (1.3.6) Required by grants, funding agenciesRequired by grants, funding agencies
Regular and continuous evaluationRegular and continuous evaluation Identifies areas to work on for Identifies areas to work on for
improvementimprovement
Identify Star PerformersIdentify Star Performers
Levels of EvaluationLevels of Evaluation
ScreeningScreening DiagnosticDiagnostic Early InterventionEarly Intervention State ProgramState Program Financing the programFinancing the program
Screening LevelScreening LevelStatisticsStatistics
Number of live birthsNumber of live births Number and percent screenedNumber and percent screened Number and percent missedNumber and percent missed Number and percent referredNumber and percent referred
Information needed to Information needed to identify possible solutionsidentify possible solutions
Equipment at each hospitalEquipment at each hospital Screening protocolScreening protocol ScreenersScreeners Screener trainingScreener training Designated program coordinatorDesignated program coordinator Notification of parent/physician/stateNotification of parent/physician/state Tracking protocolTracking protocol
Diagnostic LevelDiagnostic LevelStatisticsStatistics
Number and percent obtaining Number and percent obtaining outpatient testingoutpatient testing
Number and percent identified with a Number and percent identified with a hearing losshearing loss
Average time lag between screening Average time lag between screening and diagnostic testingand diagnostic testing
Average age of identificationAverage age of identification Number and percent lost to follow-upNumber and percent lost to follow-up
Information needed to Information needed to identify possible solutionsidentify possible solutions
Number of pediatric test sites with Number of pediatric test sites with appropriate equipmentappropriate equipment
Location of test sitesLocation of test sites Audiologist compliance with Audiologist compliance with
reporting proceduresreporting procedures Protocol for linkage with EIProtocol for linkage with EI
Early Intervention LevelEarly Intervention LevelStatisticsStatistics
Number and % enrolled in EINumber and % enrolled in EI Number and percent lost to follow-upNumber and percent lost to follow-up Average age enrolled in EIAverage age enrolled in EI Average age fit with amplificationAverage age fit with amplification Average time lag between diagnosis Average time lag between diagnosis
and interventionand intervention
Information needed to Information needed to identify possible solutionsidentify possible solutions
Timeliness of referrals to EI following Timeliness of referrals to EI following diagnosisdiagnosis
Timeliness of intervention following Timeliness of intervention following enrollmentenrollment
Training/knowledge of EI case Training/knowledge of EI case managers on issues related to hearing managers on issues related to hearing lossloss
Reporting protocol from EI to State Reporting protocol from EI to State EHDI coordinatorEHDI coordinator
State Program LevelState Program LevelSupportSupport
Parent-to-parent family supportParent-to-parent family support Dissemination of resources for familiesDissemination of resources for families Availability of medical home for all Availability of medical home for all
newbornsnewborns Availability of cultural and linguistic Availability of cultural and linguistic
family supportfamily support Performance feedback from state to Performance feedback from state to
hospitalshospitals
Tracking and Quality Tracking and Quality AssuranceAssurance
Program improvement over timeProgram improvement over time Identification of expected number of Identification of expected number of
infants with hearing lossinfants with hearing loss Attainment of program goals (1.3.6)Attainment of program goals (1.3.6) Existence of periodic and ongoing Existence of periodic and ongoing
evaluation, action plan, and monitoringevaluation, action plan, and monitoring Identification & implementation of Identification & implementation of
educational needseducational needs
Procedural Issues – keeping your Procedural Issues – keeping your head above water!head above water!
Hospital Site VisitsHospital Site VisitsEVALUATION CRITERIA
INPATIENT SCREENING ___ >98% of infants born are screened ___ >90% of infants screened pass initial screening ___ All births recorded into tracking system (Hi*Track)
OUTPATIENT RESCREENING ___ >90 of outpatients are rescreened prior to two months of age ___ 100% of infants needing outpatient screening are scheduled prior to discharge ___ PCP notified of need for follow up rescreening
DIAGNOSTIC FOLLOW UP ___ Diagnostic evaluations are completed by 3 months of age ___ All infants identified with hearing loss will receive appropriate medical, audiologic and
educational intervention services before 6 months of age ___ Results of diagnostic evaluations are reported back to the State ___ Physicians are notified of positive identifications – all infants with hearing loss will have
a medical home
FAMILY SUPPORT ___ Families of children positivley identified are referred to early intervention ___ All families receive culturally competent family support
REPORTING ___ Hospital participates in States EHDI tracking and surveillance System to minimize loss to
follow up. ___ Completes data transfer by required date as per state (ie. 10th of each month) ___ Reports transferred babies ___ Provides timely data updates on individual babies as requested
TRAINING ___ Program has competency guidelines for screeners ___ Trainers are experienced and competent according to program standards for screeners ___ Coordinators attend coordinator meetings References: T. Foust, MCHB, CDC and JCIH components/standards for evelaution, IHC evaluation standard
Montana Universal Newborn Hearing Screening
Program Evaluation
Hospital: _____________________________________ Date of Evaluation: ________________________________ Rating: Excellent = Successfully completes 100% of criteria during evaluation period Good = Successfully completes 75% of criteria during evaluation period Fair = successfully completed 50% of criteria during evaluation period Unsatisfactory – Successfully completed <50% of criteria during evaluation period
Inpatient Screening ____ Excellent ____Good ____ Fair ____ Unsatisfactory Comments:
Outpatient Screening ____ Excellent ____Good ____ Fair ____ Unsatisfactory Comments:
Diagnostic Follow-up ____ Excellent ____Good ____ Fair ____ Unsatisfactory Comments:
Reporting ____ Excellent ____Good ____ Fair ____ Unsatisfactory Comments:
Training ____ Excellent ____Good ____ Fair ____ Unsatisfactory Comments:
Program Summary ____ Excellent ____Good ____ Fair ____ Unsatisfactory Comments:
Information needed to Information needed to identify possible solutionsidentify possible solutions
Existence of financial support for Existence of financial support for diagnostic testing, and amplificationdiagnostic testing, and amplification
Existence of a hearing aid loaner programExistence of a hearing aid loaner program Mechanism for: Mechanism for:
Informing familiesInforming families
Informing practitionersInforming practitioners
Dissemination of materialsDissemination of materials
How to EvaluateHow to Evaluate
Hospital surveysHospital surveys Physician surveysPhysician surveys Parent surveysParent surveys Patient focus groupsPatient focus groups Getting patients back for follow up Getting patients back for follow up Data AnalysisData Analysis Hospital site visitsHospital site visits
Hospital SurveyHospital Survey
Physician SurveyPhysician Survey
Parent SurveysParent Surveys
Getting Patients Back for Getting Patients Back for Follow UpFollow Up
How are programs getting patients How are programs getting patients back for follow up?back for follow up?
Audiologists are keyAudiologists are key
Data AnalysisData Analysis
Importance of tracking software Importance of tracking software Is it flexible enough to generate a Is it flexible enough to generate a
wide variety of program statistics?wide variety of program statistics? Is it compatible with a variety of Is it compatible with a variety of
programs and equipment?programs and equipment? ExamplesExamples
Lessons Learned From Site Lessons Learned From Site VisitsVisits
Level of commitment to program is Level of commitment to program is evidentevident
Challenges are brought to life Challenges are brought to life Importance of onsite problem solvingImportance of onsite problem solving Equipment and data management Equipment and data management
processes are clearprocesses are clear Staff input reflects program healthStaff input reflects program health
Summary Summary
Evaluation takes time and effortEvaluation takes time and effort Must be well plannedMust be well planned