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Measuring Benchmarks Measuring Benchmarks and Quality Indicators for and Quality Indicators for
Early InterventionEarly Intervention
Measuring Benchmarks Measuring Benchmarks and Quality Indicators for and Quality Indicators for
Early InterventionEarly InterventionDawn M. O’Brien, M.Ed. EI/ECSEDawn M. O’Brien, M.Ed. EI/ECSE
Nannette C. Nicholson, Ph.D. CCC-ANannette C. Nicholson, Ph.D. CCC-AJudith E. Widen, Ph.D. CCC-AJudith E. Widen, Ph.D. CCC-A
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Introduction
Local
State
Federal
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Kansas •105 Counties•37 Networks
–Leavenworth County Infant-Toddler Services: tiny-k program
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Background• Performance Measures
– Principles– Benchmarks– Quality Indicators
• JCIH Position Statement
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Focus• Joint Committee on Infant Hearing 2000
Position Statement– Principle 3 – Early Intervention
• Six Benchmarks• Ten Quality Indicators
– Principle 8 • Data collection
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Benchmarks for Early Intervention
1. Enrolled prior to 6 months of age
2. Professional personnel & communication options
3. Use of amplification within one month of confirmation of hearing loss
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Benchmarks for Early Intervention
4. Audiologic monitoring not to exceed three months
5. Language is developmentally appropriate
6. Family demonstrate self-advocacy
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Matching Benchmarks & Quality Indicators
• Percentage of infants before 6 months of age
• Percentage…with professional personnel who are knowledgeable
1.Enrolled prior to 6 months of age
2. Professional personnel & communication options
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Matching Benchmarks & Quality Indicators
3.Use of amplification within one month of confirmation
• Percentage of infants with who begin use of amplification within one month of confirmation of the hearing loss
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Matching Benchmarks & Quality Indicators
4. Audiologic monitoring not to exceed three months
• Percentage … receive monitoring at intervals not to exceed 3 mo.
• Number of follow-up visits in the first year
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Matching Benchmarks & Quality Indicators
5. Language is developmentally appropriate
• Percentage of language evaluations every 6-months
• Percentage of infant’s language equal to hearing peers
• Percentage of achieved outcomes on IFSP
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Matching Benchmarks & Quality Indicators
6. Family demonstrates self-advocacy
• Percentage of families who refuse EI
• Percentage of families who participate in and express satisfaction with self-advocacy
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Problem• Who is responsible for reporting data?• Is the information available?• If so, where is the information located?
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Question?• Does our network collect the data
necessary to report information to the state on Benchmarks and Quality Indicators for Early Intervention?
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Method• Subject Selection
– Criteria– Population
• Procedure – Matching Benchmarks and Quality
Indicators– Database Design– Retrospective Chart Review
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Subject SelectionCriteria
• Birth to three • Enrolled in Early Intervention in
Leavenworth County after 1999• Hearing loss greater than 20 HL
dB bilaterally
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Population• 260 (1999 – 2003) Part C Eligible
Infants and Toddlers– 5 children diagnosed with >20 dB
hearing loss sensorineural or conductive•4 actively followed by an
audiologist and early intervention
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Matching Benchmarks & Quality Indicators
• Percentage of infants before 6 months of age
• Percentage…with professional personnel who are knowledgeable
1.Enrolled prior to 6 months of age
2.Professional personnel & communication options
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CalculatingQuality Indicators
1. Percentage of infants with hearing loss who are enrolled … before 6 months of age a. # < 6 months/# HL in program
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Database Design
1. Enrolled prior to 6 months of agea. Date of birthb. Date of enrollment (referral date)
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RetrospectiveChart Review
• Intake Form • Individual Family Service Plans • Audiology reports• Speech language evaluation reports• Speech evaluation test forms• Progress notes• Anecdotal notes
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Results1. Percent enrolled prior to 6 months of
age (60%)– Child 1 = 2 mo – Child 2 = 2 mo – Child 3 = 13 mo – Child 4 = 11.5 mo– Child 5 = 1 mo
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Results2. Professional personnel &
communication options• Not included in this study
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Results3. Percent use of amplification within one
month of confirmation (0%)• Child 1 = 3/01-6 mo +
Contraindication• Child 2 = 3/01 - no hearing aid fit date• Child 3 = no ABR date/hearing aid fit
date• Child 4 = 4/01 - no hearing aid fit date• Child 5 = Soundfield AC/ no hearing
aids
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Results4. Percent of infants …audiologic
monitoring not to exceed three months (0%)
• Child 1 = 9/01, 12/01, 6/02, 10/02, 11/02
• Child 2 = no hearing aid fit date • Child 3 = no hearing aid fit date• Child 4 = no hearing aid fit date
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Results4. Number of follow-up visits in the first
year– Child 1 = 2 Visits– Child 2 = no hearing aid fit date– Child 3 = no hearing aid fit date– Child 4 = no hearing aid fit date
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Results5. Percent of children with language
evaluations every six months (0%)– Child 1 = 3/01, 10/01, 4/02– Child 2 = 3/01– Child 3 = 4/02, 12/02– Child 4 = 2/03
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Results5. Percent of infants with language equal
to hearing peers (0%)– Unable to determine
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Results5. Percent of achieved IFSP outcomes
(0%) • Child 1 = not met• Child 2 = not met• Child 3 = not recorded• Child 4 = not recorded
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Results6. Family self-advocacy
– Refusal• Not included in study
– Express satisfaction with self advocacy• Not included in study
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Conclusion• Depends on the communication
between the early intervention program and the audiologist
• Standard data collection methods should be established
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The End
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Database Design
1. Enrolled prior to 6 months of agea. Date of birthb. Date of enrollment (referral date)
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Database Design2. Professional personnel &
communication options a. Information is not available in
chart
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Database Design3. Use of amplification within one month
of confirmation
a. Date of ABRb. Documented medical
contraindication c. Date of medical clearance d. Documented family consente. Date of hearing aid fit
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Database Design
4. Audiologic monitoring not to exceed three months
a. Date of hearing aid fitb. Date of each audiology contact
documentation in the child’s file
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Database Design5. Language is developmentally
appropriatea. Date of birthb. Date of each language evaluation c. Corresponding developmental
leveld. Corresponding language agee. Achieved IFSP outcomes
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Database Design
6. Family self-advocacya. Information is not available in
chart