Welcome to How to Increase Patient Satisfaction

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1 Welcome to How to Increase Patient Satisfaction Presenter: Mary Leisses, MS Director of Network Education and Training Starkey Hearing Technologies Starkey.com IHS Organizers Ted Annis Senior Marketing Specialist Carrie Pedersen Member Services Supervisor

2 Housekeeping This presentation is being recorded CE credit is available! Visit ihsinfo.org for details Note taking handouts are available at ihsinfo.org on the webinar page. Feel free to download now!

3 Agenda Satisfaction is a process, not an outcome Pre-fitting Tools Fitting Tools Post-fitting Tools Q&A (enter your questions in the Question Box any time)

4 SATISFACTION IS A PROCESS, NOT AN OUTCOME

5 Why isn t They are happy good enough? Research has shown that a comprehensive protocol has a major impact on: Hearing aid brand loyalty; Utility of hearing aids; Positive-word-of mouth advertising; Satisfaction with benefit achieved; Hearing handicap reduction; and Hearing aid usage and reduction of hearing aids in the drawer

6 Why isn t They are happy good enough? Kochkin, et al, Hearing Review 2010

7 Why isn t They are happy good enough? Kochkin, et al, Hearing Review 2010

8 PRE FITTING

9 Pre Fitting Hearing Loss Simulator COSI Demo Care Plan

10 Hearing Loss Simulator Explanation of Test Results Hearing Loss Simulator Impactful visual depiction of patient s hearing loss

11 Client Orientated Scale of Improvement COSI An open scale designed for the patient to select which environments are most important for them This is a great tool because it truly validates what is most important to the patient A version of this can be found on the Hearing Healthcare Report form It is also found in the NOAH software

12 Client Orientated Scale of Improvement A paper version can be printed out It is designed to be interactive between clinician and patient Much of the information would be obtained via the discovery process

13 Client Orientated Scale of Improvement

14 Client Orientated Scale of Improvement As a validation tool, it helps to keep patient and clinician focused on areas that are most important Going forward, it allows continued validation and to potential demonstrate improvement in quality of life as new situations gain importance

15 Demonstration As midlife approaches, people increasingly draw on right-brain functions. They begin relying less on left brain sequential reasoning and more on emotions, aka gut feeling or intuition. To arouse the strongest attention, messages should be rich in sensory stimuli Jim Gilmartin, Coming of Age, Inc.

16 Demonstration 1 Need = 1 Solution = 1 Demo Demonstrate benefit for the patient s ONE most important need Audibility Distance Hearing in Noise Wireless Accessories TV Cell phone Remote microphone

17 Demonstration Transition into recommendation with confirmation of Demo Audiologist Isn t it great to be able to hear the TV like this Mr.? Mrs., what would it mean to you if your husband could hear the television like this?

18 Care Plan

19 FITTING

20 Fitting Speech Mapping Speech In Noise Testing Homework IFF-it Reading Out Loud Auditory Training/Brain Games

21 Why Speech Mapping? I know what you are thinking. One more thing you want us to do. I don t have any extra time for this stuff Equipment is soooo very expensive!

22 Why Speech Mapping Allows patient and 3 rd party to see what is being heard Allows the clinician to see what the patient may not be able to describe New wireless technology allows more flexibility and comfort and speed in completing the protocol Moore, 2008

23 Why Speech Mapping Decrease follow visits by 50% W/O SM W/ SM Patients 13 50% Reduction 12 Follow Up Visits FU per Pt % Reduction Cunningham, 2002 More successful/satisfied patient 76% of patients with above average success were fit in 1 or 2 visits 47% of patients with belowaverage success required 4 to 6 visits 64% of practices do NOT do this Kochkin, 2011

24 Speech Mapping Verification Goal: quick verification of HA response to average inputs Displays Moderate Fitting target by default (for 65 db SPL or operator s preferred level) Optionally, you can display soft and/or loud targets This example also shows patient s thresholds in db SPL.

25 Speech Mapping Verification The thin green line is the target The thicker green band is the mapped speech signal Goal is to have green band centered on green line What do you see here?

26 Speech Mapping Counseling Set-up Input+Gain Soft and Loud curves

27 Speech Mapping Counseling Explanation Soft vs Loud is ideal audible range for hearing 90% of signal should fall within this range

28 What are we looking at? The blue and purple mark the range for soft to loud speech If sound falls below the blue line, you would struggle to hear it The gold bars is what you hear without the hearing aids Our goal is to get at least 90% of all speech between the blue and purple The blue/red bars show what you can hear now with the hearing aids Patient speak

29 Realistic Expectations Why not say All? Why not say All?

30 Why measure SNR Loss? It s the #1 complaint of hearing-impaired patients It can t be reliably predicted from the pure tone audiogram or other standard audiometric tests

31 An Example PTA = 53/55 WRS = 80%/84% PTA = 52/53 WRS = 76%/80% SNR Loss = 3 db, 1 db SNR Loss = 9 db, 9 db

32

33 QuickSIN

34 QuickSIN Equipment you need QuickSIN CD Headphones/ear inserts Set up CD in the audiometer Patient in Sound Booth

35 QuickSIN One-minute method for estimating number of hair cells that are missing 1. The dusty bench stood by the stone wall 2. We dressed to suit the weather of most days 3. The water in this well is a source of good health 4. That guy is a writer of a few banned books 5. The door was barred, locked and bolted 6. A big wet stain covered the floor +25 db +20 db +15 db +10 db + 5 db + 0 db SNR deficit

36 SNR Loss Assists with Technology Selection SNR Loss Category Technology 0-2 db Normal Omnidirectional 2-7 db Mild Fixed or Dynamic Directional 7-15 db Moderate Dynamic or Adaptive Directional >15 db Severe FM or Remote Microphones

37 So you are going to fit a hearing aid We need to realize Our patients think it will work perfectly everywhere Family thinks a hearing aid gives super human hearing They are only going to hear what they want to hear What is our reality? None of the above happens

38 What does a hearing aid do? Amplifies soft sounds in environment Reduces loud sounds in environment Shouldn t that be enough? Does a hearing aid know what to amplify and what to reduce? NO!

39 So how do we handle this? Words you will never use Always Removes Words you can use Comfort Focus

40 Examples Never say Removes all background noise Will only amplify your wife s voice Ok to say Provides comfort in busier environments Will help you focus on speech How are these statements different?

41 Learning to hear again We need to counsel on They are going to hear things they haven t heard for awhile IFF it process Identify the new sound Find the new sound Decide if they need to pay attention or can forget it Have them keep a sound journal Write down new sounds they discovered Promote positive stories

42 Learning to hear again Stay away from negative statements Things are going to be really loud. Restaurants are really noisy. Write down what you don t like and we will make changes. Focus on the positive How much fun was it playing games w/the grandkids? What sounds of life have you been missing? How great is it not to fight over the TV?

43 Learning to hear again If you have a Nervous Nellie Give them a wearing schedule Give them permission to take aid out for a couple of hours Limit first few days to wearing at home only Limit places they can wear it in the outside world

44 Learning to hear again Why do they need to wear it at home? Our homes make a lot of sounds. It teaches them to ignore non-important sounds.

45 Learning to hear again Focus on what they want to improve in their life This isn t the time to take up bowling Word your verbiage specific to their world aka Discovery

46 The family We are not giving super human hearing Unaided/aided testing will reinforce this Maximum range of gain strength is 6 ft. If she is doing dishes in kitchen, he is not going to hear her perfectly in living room while watching TV They need to say patient s name first to get their attention

47 The family Have family keep journal in regards to different environments What did they think? Was it a busy environment? Where were they sitting?

48 Other things to think about Introduce them to Brain Games Assign a couple of levels as Homework This is our version of Aural Rehab Helps with hearing in busier situations Involves family There is some ownership involved

49 Brain Games Read My Quips - BrainHQ Angel Sound - LACE (Listening and Communication Enhancement): Therapy for the Brain

50 Bottom line? Get them excited about hearing their life again! They came in looking for help Our job is to get them ready for a great journey However It does rain Rain is good We will counsel to using an umbrella

51 POST FITTING

52 Post Fitting IOI-HA Long Term Care Plan

53 IOI:HA 8 Questions 7 questions cover outcome domains 8th question quantifies perceived impact (handicap) of hearing loss This question is used to determine which Norm Data Set should be uses Let s start at the end..

54 IOI:HA The norms are divided into two groups Mild-Moderate Mod-Severe + Dependent upon how the patient answers this question, the scores for the other questions are graphed on a different plot

55 IOI:HA

56 IOI:HA The other 7 questions Use (Use) Benefit (Ben) Residual Limitations (RAL) Satisfaction (Sat) Participation Restrictions (RPR) Impact on Others (Ioth) Quality of Life (QoL)

57 IOI:HA The first question looks at, overall, how much is the device used

58 IOI:HA Next we look at benefit in a situation the patient was seeking help This is the crossover between Direct and Indirect We may not know what the exact situation is We know it is of value to the patient

59 IOI:HA The rest of the questions look at other aspects Most are not covered in other scales

60 IOI:HA If our patient had rated their hearing loss moderately severe, we can see how they do compared to the norms

61 IOI:HA

62 IOI:HA

63 IOI:HA Quality of result varies with norms and therefore perceived impact of hearing loss

64 Long Term Care Plan Every 3 to 4 Months Doesn t have to be long Clean and check Quick conversation on how it is going Annual Follow Up Repeat Verification/Validation Test Hearing Discuss what is plan for next year

65 Enter your question in the Question Box on your webinar dashboard Questions

66 Contact Mary Leisses: Visit For more info on obtaining a CE credit for this webinar, visit THANK YOU FOR ATTENDING!

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