A representative from OZ Data Systems is present on the teleconferences and minutes are sent to hearing screeners and data entry staff from all facilities and Public Health Centers.
A critical element to determine loss to follow-up is accurate entry of data into the EHDI database by audiologists. This information is essential to verify infants received appropriate and timely diagnostic evaluation after an infant has a failed hearing screening. The audiologist is also an important link to the primary care provider and referrals for early intervention services and family support. Initial training of audiologists was conducted in 2005; however it was not until a refresher training in 2007 that audiologists began to use the database. The State EHDI Program has provided ongoing information to the audiology community that this is a requirement of the Alaska mandate beginning January 2008. A database user group will be established by OZ Systems to improve and simplify data entry for audiologists. Follow-up training for audiologists will be scheduled in Anchorage to improve consistency in data entry.
The National Initiative for Children’s Healthcare Quality (NICHQ) model for improvement utilizing the “Plan-Do-Study-Act” (PDSA) cycle will be developed to determine if the database trainings influence the rate of children lost to follow-up vs. lost to documentation for a particular hospital. Along with the quarterly practice profile, the hospital will be sent a list of children identified as missing their newborn screening or needing follow-up for a failed screen on a quarterly basis. The hospital will check this list against their records, determining if the family and the child’s primary care provider were contacted and notified of screening results. This project will initially be implemented in a hospital with a strong birth screening program and a known commitment to follow-up. Change in lost to follow-up rate will be followed on a monthly basis. This rate of change will be monitored during the quality improvement project period, and also compared to the hospital’s previous rate during the same time period for the previous year.
A second model for improvement using the PDSA Cycle to decrease the number of children lost to follow-up will involve a fax-back system between to the infant’s primary care provider and the State EHDI Program. The EHDI Health Program Associate (HPA) will prepare a weekly report of infants/children with a failed screening by facility and the report will be faxed to the