Outpatient Screening: Introduction
Best Practice Guidelines
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Improvement in Action
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Closing the Follow-up Gap: An EHDI Case Study
The Visit to the Outpatient Clinic
The Xiong family arrive at Prairie View Pediatric Audiology Clinic with their one-month-old son Jon. Jon was born at a hospital just a few miles away. The audiologist is prepared for the Xiong visit because she was alerted to the family’s referral through the WE-TRAC system. WE-TRAC indicated that this baby was screened using ABR technology at the hospital and his right ear did not pass. The audiologist also noticed in WE-TRAC child’s chart that the family required a Hmong interpreter and has one available for today’s appointment.
After welcoming the Xiong family back to her office, the audiologist begins the screening appointment by conducting an ABR screen in each ear. This time the child refers on the left ear rather than the right ear as reported by the hospital. The audiologist continues the screening appointment by conducting OAE’s, which are present bilaterally. The results verify that this child will require a full audiologic evaluation.
The results and need for a follow-up evaluation are conveyed verbally through the translator to the family. The family is very disappointed and expected they would have a conclusive diagnosis after today’s visit. The audiologist apologizes but encourages them to make the follow-up appointment at the reception desk on the way out. The family shares that they will be moving to live with family in the western part of the state in the coming week. Undeterred, the audiologist searches the Find Wisconsin Providers directory on the improveehdi.org website and locates an audiologist who can perform sedated ABR evaluation. The family provides the clinic contact information to the receptionist who schedules a diagnostic evaluation appointment at Western Region Audiology Clinic.
Discussion Points
- What additional improvement strategies could the outpatient facility have used that would help the family follow-up?
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Why is rescreening both ears important?
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This baby was screened with ABR equipment as an inpatient. How does this impact the outpatient re-screening process?
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How did the communication practices of this clinic assist or fail to assist the familiy in getting appropriate follow-up care?
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How could the GBYS Program have been utilized in this scenario? What would the benefit have been? Who might have benefited?
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How could this clinic have prepared the family better for the next step in the process?
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How do you predict that the time between this visit and follow-up care could impact this family's EHDI experience?
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If this family's follow-up visit had gone exactly as it should have, what would have been different?