health and wellness for all arizonans azdhs.gov dr bradley golner, md phoenix pediatrics az ehdi...
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Health and Wellness for all Arizonansazdhs.gov
Dr Bradley Golner, MDPhoenix PediatricsAz EHDI Chapter Champion
Health and Wellness for all Arizonansazdhs.gov
EHDI Goals
Understand the role of the Medical Home
Improve Communication with parents
Help PCPs to understand the screening status of their infants
Help PCPs to understand their patient’s diagnosis
Reduce Loss to Follow-up
Health and Wellness for all Arizonansazdhs.gov
EHDI Goals
• Remember 1-3-6– Hearing screening testing for all babies should be
complete by 1 month of age– Diagnostic evaluation by audiology completed by
three months of age– Early Intervention no later than 6 months of age if
hearing loss present
Health and Wellness for all Arizonansazdhs.gov
Developmental Emergency
• Critical developmental window• EHDI goals are in place to avoid
developmental delays• Not diagnosed/late diagnosis: $500,000/life
Health and Wellness for all Arizonansazdhs.gov
Empower EHDI Chapter Champions to work with stakeholders and their respective AAP chapter to conduct education and training in an effort particularly focused on reducing the rate of loss to follow-up/documentation.
Increase knowledge regarding newborn hearing screening and the EHDI system
Provide practical strategies for improving systems regarding newborn screening/surveillance and link systems within the state.
Health and Wellness for all Arizonansazdhs.gov
"The primary care physician must assume responsibility to ensure that audiological assessment is conductedon infants who do not pass screening and must initiate referrals for medical specialty evaluationsnecessary to determine the etiology of the hearing loss."
Joint Committee on Infant Hearing, 2007http://www.jcih.org/
Health and Wellness for all Arizonansazdhs.gov
Newborn Screening Diagnosis Intervention
Babies identified with a hearing loss should be referred to ENT/Otology and Early Intervention (AzEIP)
Coordinate referrals to specialty providers based on etiology of hearing loss
Ongoing Monitoring—results, treatment, education and family support
Health and Wellness for all Arizonansazdhs.gov
At 1st well‐baby visit—Check hearing screening results on back of immunization card or hospital discharge summary for referred or missed/incomplete screens
Refer well babies failing inpatient screen for outpatient screen
Refer those failing inpatient NICU, and those failing both inpatient and outpatient (as well babies) for an Auditory Brainstem Response test by an audiologist specializing in pediatrics (may require sedation/anesthesia if approaching six months of age or older.)
Health and Wellness for all Arizonansazdhs.gov
Parent Communication
• Every newborn baby is PERFECT!!!• Tommy—3.5 years old, failed newborn screen• What not to say• Educate and Empower the parents
Health and Wellness for all Arizonansazdhs.gov
Communicating with PCPs
• Blue Vaccine cards—why they are important• Reporting results-hospital charts and EHDI• Notifying the PCP for babies who refer• Educating the PCP
Health and Wellness for all Arizonansazdhs.gov
Reducing Loss to Follow-up
• Loss to Follow-up… #1 problem we all face
• We all can improve:– Screeners- communicating with parents, PCP– EHDI team-notify and educate – Audiology-NICU babies, empower parents, PCP– EHDI-ensure appt are not missed
Health and Wellness for all Arizonansazdhs.gov
o Between the newborn period and school age the incidence of hearing loss doubles
o Most common risk factors for late onset or progressive loss are: CMV, Meningitis,
o Illness, Head Injury, and Family History
o Consult audiologist on ongoing audiological monitoring beyond the newborn period