Improving the System of Care for Infants and Children with Early Hearing Loss
New Supplement to Pediatrics on Improving the System of Care for Infants and Children with Early Hearing Loss.
National data suggest that up to half of U.S. babies that do not pass their newborn hearing screens are lost to follow-up/lost to documentation. A Supplement to the August 2010 issue of Pediatrics entitled “Improving the System of Care for Infants and Children with Early Hearing Loss” features a series of articles highlighting the challenges that remain to be addressed to ensure early diagnosis and intervention for all children with early hearing loss. In a Foreword to the supplement, Former Surgeon General C. Everett Koop reflects on how far we have come in implementing the screening program, and expresses optimism that remaining problems can be solved through collaborative efforts, data-driven quality improvement activities, and creative uses of new technology.
Shirley Russ MD MPH and colleagues report on the outcome of the “Accelerating Evidence into Practice” workshop held in January 2008 with representatives from the Agency for Healthcare Research and Quality (AHRQ), the Centers for Disease Control (CDC), the Health Resources and Services Administration- Maternal and Child Health Bureau (MCHB), the National Institute on Deafness and other Communication Disorders, the National Institute of Child Health and Human Development and other federal partners, and with parents and representatives of the deaf/hard of hearing (DHH) community. The group worked on action steps to accelerate the movement of evidence-based recommendations into practice, and highlighted a greater role for parents and families in contributing to system transformation.
Shanna Shulman and colleagues from Mathematics Policy Research report on their evaluation of the universal newborn hearing screening program, Todd Houston PhD and colleagues report on an analysis of the impact of federal privacy regulations on the provision of effective EHDI programs, and Peg McManus and Stephanie Limb et al author two papers on the variations existing across states in medical reimbursement rates for hearing services, and in the financing of hearing aids.
Challenges with providing intervention services in rural areas have led to interest in teleintervention. Melissa McCarthy and her colleagues report on their experiences implementing a teleintervention program for children who are deaf or hard of hearing in New South Wales, Australia. They consider future research needed on the teleintervention model and its potential applicability to the U.S. system. Finally Shirley Russ, Janet Des Georges (Hands and Voices) and Doris Hanna (NICHQ) report on their experiences with a large eight-state learning collaborative in which parents and professionals worked together to apply quality improvement techniques to minimizing loss to follow-up after newborn hearing screening.
In a preface to the articles, supplement editors Shirley Russ (Cedars-Sinai Medical Center, UCLA Center for Healthier Children), Karl White (National Center for Hearing Assessment and Management (NCHAM)), Denise Dougherty (Agency for Healthcare Research and Quality (AHRQ) and Irene Forsman (HRSA-MCHB) express their hope that states will find the contents useful as they work on improving their systems of care for all children with hearing loss.
Dr. Russ commented “Pediatricians want to make sure that their patients receive the best possible hearing health care, but system issues can present real challenges. For example, in some areas, less than half of newborns referred for further testing after their initial hearing screen had their primary care provider correctly identified. It is very hard to put the concept of “medical home” into practice unless we can get these basic steps right.”
The supplement can be accessed at http://pediatrics.aappublications.org/content/vol126/Supplement_1/