BC Early Hearing Program

Transcription

1 BC Early Hearing Program A service of BC Children s Hospital and the Provincial Health Services Authority April 1, 2008 March 31, 2009 Annual Report

2

3 Contents Introduction... 2 Background... 3 Key BCEHP Facts... 4 Program Achievements... 4 How BCEHP Supports Families... 8 Information Management Regional Highlights Service Provider Training and Education Future Directions Appendix A Governance Appendix B - BCEHP Program Statistics

4 Introduction In March 2005, government announced a commitment to improve early childhood development. The BC Early Hearing Program (BCEHP) was one part of an integrated cross-ministry strategy for addressing dental, hearing and vision concerns in the early childhood years (birth to five years). BCEHP is a program of Children s Hospital, a branch of the PHSA and an integrated program in partnership with the regional health authorities and the Ministry of Children and Family Development (MCFD). BCEHP provides equitable, coordinated and effective early detection and intervention services for babies from birth up to five years of age who are deaf or hard of hearing and their families. The overall goal of BCEHP is to enable the best possible outcomes for children with hearing loss at birth or soon after. This is accomplished by helping families with support and resources critical for their child s communication and social development and educational achievement. The program is delivered and managed through the existing infrastructures of the Provincial Health Services Authority (PHSA), BC Children s Hospital, the Ministry of Children and Family Development (MCFD), regional health authorities, contracted service provider agencies and other independent private health service providers. Partnership and consultation with physicians, families, community agencies, service providers and universities is an integral part of the program. Our vision is the best outcomes for young children in BC with congenital or early onset hearing loss. Our mission is to positively change the future of deaf and hard of hearing babies and their families through early detection and intervention services for children aged birth to five years. This provincial program provides young children and their families access to the services and supports required for communication development. Our mandate is an integrated early hearing screening and intervention service for all infants and young children in BC. 2

5 Background The BC Early Hearing Program is an early hearing detection and intervention (EHDI) program. EHDI programs are widespread and the standard of care in most industrialized countries. BCEHP and other EHDI programs are not only screening programs. They are a tightly integrated sequence of activities, including: universal newborn hearing screening; diagnostic audiology to confirm and define the hearing loss; medical management to diagnose the etiology, evaluate complications and concomitant disorders, predict the progression of hearing loss and prevent or manage the deterioration of hearing loss; integrated family service plans; technological interventions including hearing aids, cochlear implants; and services to optimize the development of language, speech and communication. There are well documented benchmarks and targets for EHDI programs, which BCEHP adopts to measure the program progress. Congenital, permanent hearing loss (PHL) is a common serious health condition. Untreated, it compromises development, family communication, early literacy, educational achievement, employability, and quality of life. Each year in BC close to 45,000 babies are born. Hearing loss is a relatively common disorder. PHL is typically found in about two of every 1000 live births and an additional one in every 1000 live births will have medically treatable hearing loss. This translates to about new cases each year in BC. Hearing loss is more common than any other condition for which newborn screening occurs, such as congenital hypothyroidism (one in ) and cystic fibrosis (one in 3500). 1 Births by Health Authority There is good evidence that universal newborn hearing screening leads to much earlier diagnosis and initial intervention, as well as substantial improvements in language development at school entry and beyond 2. For example, Kennedy and colleagues found that Universal newborn screening and early confirmation of permanent childhood hearing impairment had clinically important benefits to the language ability of children at primary school age. 3 There are documented improved vocabulary scores for early identified children. 4 A recent study 5 also confirms significant improvement in reading and communication skills in children who received screening. BC is well on its way to achieving early detection of hearing loss and early access to communication supports for infants with hearing loss within the first six months of life. 1 Kaye, USPSTF, Kennedy et al., Moeller, McCann et al,

6 Key BCEHP Facts Implementation of screening sites across BC continued (complete implementation achieved in September 2009). The program achieved screening on 36,000 babies, representing over 80 per cent of babies born per cent of babies were found to be positive on screening. 87 per cent of positive cases had hearing levels confirmed. 81 confirmed cases of hearing loss were found, approximately 2.2 per 1000 births. Over 90 per cent of babies with hearing loss received intervention either through direct service or regular language monitoring. Over 50 per cent of the families of babies with hearing loss accessed support through the Guide by Your Side Program. Intervention services were accessed by families at 2.5 months. The BCEHP Hearing Equipment plan provided hearing aids to 47 children in the year (children below five years of age). The program s public website has been further expanded following feedback from stakeholders, particularly parents of children with hearing loss. Five training sessions were provided to screeners, interventionists and audiologists across the province, reaching over 300 BCEHP service providers. The BC Early Hearing Surveillance Tool Version 1.2 (BEST), the provincial information solution, was rolled out including the core audiology modules (Screening and Diagnostic Audiology) and import linkages. 4

7 Program Achievements Screening Coverage The planned implementation of the program across BC continued in As of March 2009, screening was fully implemented in the Vancouver Coastal, Fraser, Vancouver Island, Interior and PHSA (BC Women s Hospital) Health Authorities. The Northern Health Authority continued to roll out screening, with Prince George and Northern Interior fully implemented. As of March 31, 2009, over 95 per cent of BC births had access to screening. Screening was completed for 80 per cent of all births in ; an excellent rate for a partially implemented program. Once a site began screening, approximately 95 per cent of the births were screened within the first few months. Screening coverage is lowest for homebirths and babies born outside of BC, at 75 per cent. Screening Results The rate of positive screenings (babies who do not pass screening) is an important benchmark for newborn hearing screening programs. Established programs target an overall rate of two per cent, usually achieved within the first three years of full implementation, with early rates much higher. BCEHP achieved an overall rate of 2.1 per cent in its second year of partial implementation, which well exceeds international and documented standards for the early stage of implementation. Percentage of babies registered with BCEHP in Infants Registered (babies registered in BEST) NICU WELL BABY ALL BABIES TARGET HEALTH AUTHORITY FHA IHA NHA PHSA VCHA % VIHA ,918 35,252 38,170/44,451 (85.9%) Homebirths/ Out of Province births Provincial Total NOTE: As the program was not entirely rolled out during , not all babies born were registered with BCEHP. Of the babies registered (85.9% of total births), 93 per cent were screened. 6 Year 2007 Position Statement: Principles and Guidelines for Early Hearing Detection and Intervention Programs 5

8 Infants with a refer result as a percentage of infants referred NICU WELL BABY ALL BABIES TARGET 44/50-88.% 320/ % 364/ % HEALTH AUTHORITY FHA 6/8-75.% 48/50-96% 50/ % IHA Infants with a refer result as a percentage of infants referred 1/1-100% 3/3-100% 4/4-100% NHA 16/ % 123/ % 139/ % All Babies: 70% PHSA Births 4/5-80% 42/ % 46/ % (Year 1 interim target) VCHA 5/7-71.4% 35/ % 40/ % VIHA 0/0-0 3/3-100% 3/3 - (100%) Home births / Out of Province births 76/ % 574/ % 646/742-87% Provincial Total Infants with a final refer result as a percentage of infants with a final screening result NICU WELL BABY ALL BABIES TARGET 50/ % 367/ % 417/ % HEALTH AUTHORITY FHA Refer Rate: (Infants with a final refer result as a percentage of infants with a final screening result) 8/ % 50/ % 58/ % IHA 1/ % 3/ % 4/ % NHA 17/ % 145/ % 162/ % PHSA 1-3% 5/ % 48/ % 53/ % VCHA 7/ % 38/ % 45/ % VIHA 0/10-0% 3/ % 3/ % Home births / Out of Province births 88/ % 654/ % 742/ % Provincial Total 6

9 Diagnostic Audiology Assessment Results Screening is the first step in early detection. Babies who do not pass screening progress to a comprehensive diagnostic audiology assessment at one of 15 Infant Diagnostic centres located across the province. These sites provide standardized assessments by provincially trained audiologists. Provincially, 87 per cent of infants attended diagnostic assessment, with all locations achieving over 85 per cent. It is well documented that families often complete screening but do not access the diagnostic assessment for many reasons. The Joint Committee on Infant Hearing in 2007 stated: Despite the fact that approximately 95 per cent of newborn infants have their hearing screening in the United States, almost half of the newborns who do not pass the initial screening do not have appropriate follow-up to either confirm the present of a hearing loss and/or initiate appropriate intervention services. 6 The lack of integrated state-wide data systems has been cited as a contributing factor. Hearing Loss Found Confirmation of hearing loss is an important milestone in any EHDI program. Once hearing loss has been confirmed, families can begin assisting their child with their communication and overall development. The earlier this assistance is provided the better, with the best outcomes for children achieved if communication supports start before age six months. 7 In BCEHP found 81 new cases of infant hearing loss, either in both ears (bilateral) or in one ear (unilateral). Infants with Confirmed Hearing Loss by Health Authority (# of babies with confirmed hearing loss as a percentage of babies with a final refer result plus those going to straight to diagnostics) NOTE: In addition to the 81 confirmed hearing loss, there are four additional cases still uncertain or families withdrew from the diagnostic process (FHA: 2; VCHA: 2) 6 Year 2007 Position Statement: Principles and Guidelines for Early Hearing Detection and Intervention Programs 6 Year 2007 Position Statement: Principles and Guidelines for Early Hearing Detection and Intervention Programs 7

10 How BCEHP Supports Families The Guide-By-Your-Side Program, an innovative and supportive program for parents of children newly diagnosed with hearing loss, started for BC families in The program provides emotional support and specialized knowledge from trained parents of children who are deaf or hard of hearing. This program has been developed by Hands & Voices, a non-profit organization dedicated to supporting families and is supported by BCEHP in BC. I found the BC Early Hearing Program Resources the parent kit binder and all the information invaluable. I don t know what I would have done without them. BCHEP has a part-time coordinator and five part-time parent guides who provide support and information to the families of children newly diagnosed with hearing loss. In their start up year, 54 per cent of families (44/81) accessed guide services. On average, guides had five contacts per family (a range of one to 19) with each contact averaging 30 minutes. Each of the guides brings a different experience to share with families, including a parent with a child who has a Cochlear implant, a parent fluent in Mandarin and Cantonese, and a parent with complex needs. I was also wondering how to get involved with the Guide by Your Side program. I found it and you helped immensely with the initial stress and decision-making of having a hard of hearing/deaf child. I would love to be able to support other parents in the same way. Timely enrolment in early intervention services is critical to realizing the benefits of early detection of hearing loss. BCEHP developed, in consultation with providers and families, a family path that helps families understand their next steps in accessing communication supports. This is summarized in BCEHP s Family Path brochure which is provided to all families once hearing loss is confirmed. Soon after diagnosis, families are contacted by the BCEHP Provincial Intervention Coordinator and provided information, guidance and support in adjusting to their child s hearing loss. All families are referred to provincial coordinating services and contact is made soon after the hearing loss is confirmed. Nearly 100 per cent of families were contacted. The Provincial Intervention Coordinator focuses on: answering parents questions about hearing loss and communication development; providing full and unbiased information about service options; and assisting families in accessing community-based and provincial early intervention program services. Families received a BCEHP parent kit soon after the initial contact. The kit is a resource containing essential information for parents of infants with hearing loss. This parent kit, along with other BCEHP family resources, is available in 11 languages. The Provincial Coordinator works closely with community audiologists and early interventionists to develop a coordinated, family-centred team approach to assist families in taking the next important steps linking them with services and supports. Over 94 per cent of the children found to have hearing loss progressed into intervention services, either direct service or monitoring of language development in the case of mild or unilateral hearing loss. Of the 82 children seen for intervention services, 67 per cent were funded through BCEHP to receive direct therapy services and 27 per cent received language monitoring. My child has a syndrome that affects her learning, so her speech development is slower than other typical children. I feel it is so important to correct her hearing loss and help her develop and learn. She is nearly five years old and I feel her speech has developed to her potential so far. 8

11 Families receive early intervention services through one of three provincial agencies that specialize in services for infants and young children with hearing loss and through local community agencies, such as child development centres and health authorities. BCEHP provides standardized assessment and therapy resource materials to all providers. BCEHP provides the first set of hearing aids to eligible children if the use of amplification is chosen by the family. In , BCEHP provided 85 hearing aids to children, with the average age of six and a half months for bilateral fittings and just over five months for unilateral fittings. Referrals by Health Authority Total (Per cent) Referred to Provincial Intervention Coordinator in NOTE: There is more than 100% of children, because an additional child was direct referred by audiologist and minimal services were provided. The child did not meet referral criteria. Number of Hearing Aids Fit in Number of Hearing Aids Fit; Bilateral and (Unilateral) Median Age and Range of Bilateral Hearing Aid Fittings Median Age (Mean Age) and [Range] of Bilateral Hearing Aid Fitting in Months Thank you for your support and looking after our family. Your letter was really touching for us and we understand that we are not alone in this difficult situation. [letter received following contact by the BCEHP Provincial Intervention Coordinator] 9

12 Information Management BC has implemented a province-wide tracking and management tool. The BC Early Hearing Surveillance Tool, BEST, is a web-based tool used by all regions for program operation, evaluation and optimization. It provides follow-up flags and communications to providers that are used to ensure that all children have access to timely services. Development continued on BEST with the implementation of version 1.2, which included initial reporting, a notification module, the core audiology module and changes based on user feedback. The first import linkages between BEST and other regional systems were implemented. This included Admissions Discharge Transfer systems importing to BEST for IHA, BC Women s Hospital, and NHA. The design phase for the VCHA PARIS clinical data system import into BEST was completed. 10

13 Regional Highlights Fraser Health Authority Home to approximately 40 per cent of the children in the province, the Fraser Health Authority (FHA) is committed to providing early hearing services that are integrated, sustainable, and use the available funding support efficiently and effectively. In , FHA completed the rollout of well baby screening at the region s final two hospitals, bringing the total to eight screening sites. In addition, a community screening clinic was opened in Mission to provide increased access to screening for families. The region now has 100 per cent of its early hearing staff trained with completed competency checks, and using the provincial data system BEST. In addition, all designated speech language pathologists in the region have attended provincial intervention training. The Fraser East Aboriginal Health Network met with the Sto:lo Nation and provided an update about the BCEHP. Aboriginal health service providers were encouraged to remind their clients about the importance of identifying early hearing loss and to promote language development. The region also has an integrated speech services protocol in place with Seabird Island Indian Band. Fraser Health surveyed families receiving services through their speech and audiology program, with an overall 86 per cent satisfaction rate with services provided. Ongoing quarterly meetings with screening and audiology staff promote communication and exchange of information between providers. Fraser Health achieved excellent screening, refer and follow-up rates, with 94 per cent of babies screened, an overall refer rate of three per cent and 87 per cent of infants receiving their diagnostic audiology assessments. There were 35 babies in the region newly identified with hearing loss during the period this report covers. 11

14 Interior Health Authority The Interior Health Authority (IHA) faces unique challenges due to its large geographical area and range of both urban and rural communities. In IHA completed the roll out of screening at 16 birthing sites. This is the largest number of screening sites for any single region in BC. One of the primary reasons for the successful roll out was the project management approach supported by a clinical lead (the Regional BCEHP Coordinator) and a project steering committee that was instrumental in involving a wide range of stakeholders, maintaining implementation focus, monitoring implementation progress, identifying and mitigating risks, and solving challenges. The active participation and dedication of more than 130 individual staff members through the planning and implementation process was critical to the success, as was the responsiveness of all partners involved in this program. The Interior Health Authority also had a strategy to ensure the engagement of Aboriginal communities in the planning of screening. Participation varied across the region and the primary focus was on Indian bands. In addition, the region included an Aboriginal representative on the steering committee and on all working groups. Presentations on BCEHP were made to the First Nations Health Directors Group and the First Nations Health Community Health Nurses in the Shuswap and the Okanagan. Updates were regularly sent to First Nations Professional practice group (Community Health Nurses). The region also participated in the Aboriginal Health Forum in Kamloops in The Interior Health Authority successfully addressed the geographical challenges by incorporating a mixed screening model which is a mix of both hospital and community based screening sites and being responsive to local need and resources. Service provider feedback was solicited through structured feedback sessions over the course of the project. The lessons learned from this feedback were captured in the project closure and evaluation documents. The Interior Health Authority achieved excellent screening, refer and follow-up rates, with 95 per cent of babies screened, an overall refer rate of 1.3 per cent and 86 per cent of infants receiving their diagnostic audiology assessments. There were 12 babies newly identified with hearing loss during the period this report covers. 12

15 Northern Health Authority Also a geographically large health authority, the Northern Health Authority (NHA) has few urban areas and low birth rates. However, building upon the success in the Prince George NICU and well baby programs, the Northern Health Authority successfully implemented well baby screening in Quesnel, Burns Lake and Vanderhoof. Critical to their success was the hiring of a regional coordinator and the active participation and dedication by many of the region s departments, staff members and community partners. The Northern Health Authority is developing an Aboriginal health strategy for all services and this will inform any further enhancements to their delivery of the early hearing program. On a local level, representation from the Aboriginal communities has been actively encouraged in the planning for screening and intervention. Health staff from local Aboriginal bands and friendship centres have also been involved in screening to maximize access to services. Developing and maintaining the capacity to manage the implementation over a large, geographical area with so few urban areas and many more rural communities is challenging. The start of their Regional coordinator in August 2008 significantly enabled the Northern Health Authority to move forward in their roll out of the program. The Northern Health Authority achieved excellent screening and follow-up rates, with 93 per cent of babies and 100 per cent of infants receiving their diagnostic audiology assessments. There were five babies newly identified with hearing loss during the period this report covers. 13

16 Vancouver Coastal Health Authority The Vancouver Coastal Health Authority was completely rolled out for the entire fiscal year. Highlights for the year included an event in Richmond held to thank the Lions Club for donating screening equipment and to highlight the implementation of the early hearing program in the community. During the year, there was increased awareness and acceptance of the provincial program and better engagement of the various professionals involved. The rollout of early hearing screening has raised awareness about pediatric audiology across the health authority. There has also been increased engagement of employees involved in the program (program assistants, audiometric technicians, audiologists). The implementation has enabled employees to learn new skills and has led to collateral effects such as a health authority wide harmonized hearing aid fee schedule for non-early hearing program patients. Vancouver Coastal Health achieved excellent screening coverage, with 95 per cent of babies screened. An overall refer rate of one per cent from screening to diagnostic assessment was achieved. Of the babies referred to diagnostic assessment, 87 per completed and received their diagnostic audiology assessments. There were 20 babies newly identified with hearing loss. 14

17 Vancouver Island Health Authority The Vancouver Island Health Authority (VIHA) rolled its early hearing screening in its final two communities in 2008, with the additions of Duncan and Port Alberni. All communities with birthing hospitals in VIHA are now screening. Screening coverage at St. Joseph s Hospital in Courtenay was increased to five days per week. Duncan and Campbell River were converted from AABR/ AABR to two stage AOAE/AABR diagnostic testing. Both of these initiatives were undertaken to reduce the hospital miss-rate in these smaller communities. For the smaller hospitals there has been a higher than anticipated number of missed or incomplete screenings. This was an issue particularly for babies returning to remote communities where screening follow up may be more difficult to access. Steps have been taken to improve screening efficiency in the hospitals and reduce need for community follow up. Providing weekend coverage in areas with smaller hospitals is an ongoing concern. Vancouver Island Health achieved excellent screening and follow-up rates, with 95 per cent of babies screened and 86 per cent of infants receiving their diagnostic audiology assessments. There were nine babies newly identified with hearing loss during the period this report covers. 15

18 Service Provider Training and Education Several provincial training sessions were held in These included: Screener training: Screeners were trained on province-wide protocols, equipment and BEST. Training was phased to match the rollout of screening sites, with two sessions provided in Screener update sessions: These sessions focused on key messages for families, infection control training, protocol review and opportunities for network and sharing practice issues across the regions. Two oneand-a-half day sessions were held in March A total of 93 screeners attended. Provincial interventionists meeting: In October 2008, a three-day session was held for designated service providers. This included a training session for new service providers which introduced BCEHP assessment protocols and practice standards. Dr. Alys Young and Gwen Carr, two internationally recognized presenters from the United Kingdom, presented on the research about informed choice and strategies for working with parents of infants identified with hearing loss. Nearly 100 interventionists attended from across the province. Provincial audiology meeting: A two-day session was held for audiologists in October 2008 that focused on program updates. An education session Staying in Step with Families: Counseling Strategies for Audiologists was provided by Dr. Kris English from the University of Akron, Ohio. The training was attended by 76 service providers, predominantly audiologists. 16

19 Future Directions This report provides a snapshot of progress made by the BC Early Hearing Program in Provincial data indicates that the program is well on track and that regional implementation of early hearing screening is being implemented as planned. The program has had important achievements this year, with the first families of children with hearing loss identified through BCEHP having access to the supports necessary to help ensure their baby s optimal development. The BCEHP provides coordination and leadership for this complex program which results in greater equity of service and improved access for families. The program strives to provide a seamless continuum of familycentred care including access to screening, specialized diagnostic and intervention services. Ongoing program evaluation and continuous quality improvement will be critical to achieving optimal outcomes. As the program continues to mature, BCEHP looks forward to when all components of the program will be implemented province-wide. The BC Early Hearing Program is necessary for parents because knowing this information early takes away a lot of the guilt that would be there if they found out about hearing loss later, alleviates parent and family stress and helps parent channel energy where it s needed for their baby a great program. I have been impressed with all the resources available for my child in regards to his hearing. The program was implemented only 5 years ago so needless to say we are quite fortunate.. it is really quite amazing. 17

20 Appendix A: Governance Ministry of Health Services (MOH) President BC Children s Hospital and Sunny Hill Centre for Children Provincial Health Services Authority (PHSA) Vice President, Inter-Hospital Services, BC Children's Hospital & BC Women's Hospital and Health Centre Regional Ministry of Children and Family Development (MCFD) Children and Youth with Special Needs Representative Regional Health Authorities Executive Sponsors and/or Representative BCEHP Provincial Steering Committee BCEHP Program Director Program Administrative Coordinator Program Assistants Regional CFOs LEGEND: Aboriginal Health Authorities IDP + AIDP Intervention MCFD MOHLS Joint Council Chair Medical Advisory Group Research Committee AIDP Aboriginal Infant Development Program BCEHP BC Early Hearing Program CFO Chief Financial Officer IDP Infant Development Program MCFD Ministry of Children & Family Development MOE Ministry of Education MOH Ministry of Health MOHLS Ministry of Healthy Living and Sport PHSA Provincial Health Services Authority Information System Manager Systems Analyst PHSA Regional Coordinator Hearing Screeners Clinical Diagnostic Audiologist Provincial Intervention Coordinator Parent Guide by Your Side Coordinator Service Coordinator Intervention Joint Council of Advisory Groups Regional Coordinators Council/Regional Screening Programs Fraser Health Parent Guides Professional Associations and Stakeholders Interior Health Northern Health Vancouver Coastal Health Vancouver Island Health Provincial Health Service Advisory Groups Audiological Diagnostics Evaluation - Information Working Group - Intervention Working Group - Technical Working Group - Subject Matter Experts Working Group - iphis/phip Working Group - ADT Working Group - PARIS Working Group Hearing Devices Intervention Medical Screening Other Working Groups - Cleft Palate Working Group - BC College Working Group Rev

21 Appendix B: BCEHP Program Statistics (as of April 1, 2010) NICU WELL BABY ALL BABIES TARGET HEALTH AUTHORITY Infants with Completed Screening as a % of Infants Registered (Infants with a final screen result as a percentage of registered infants) 869/ % 12952/ % 13821/ % 356/ % 4189/ % 4545/ % IHA 173/ % 1109/ % 1282/ % NHA 597/ % 4761/ % 5358/ % WB: 90% PHSA 326/ % 4829/ % 5155/ % NICU: 85% VCHA 426/ % 5191/ % 5617/ % VIHA 10/ % 357/ % 367/ % FHA HB/Out of Province 2757/ % 33388/ % 36145/ % Total Province 88/ % 654/ % 742/ % Total Province NICU WELL BABY ALL BABIES TARGET HEALTH AUTHORITY FHA Babies that Bypass Screening and Go Straight to Diagnostics IHA NHA WB: 90% PHSA NICU: 85% VCHA VIHA HB/Out of Province Total Province 19

22 Appendix B: BCEHP Program Statistics (as of April 1, 2010) , continued Babies with no final outcome as a percent of babies registered (Infants with no final result as a percentage of registered babies; includes deceased and moved out of province, etc. and takes out babies with a diagnostic outcome even if they were not screened ) NICU WELL BABY ALL BABIES TARGET 64/ % 726/ % 790/ % HEALTH AUTHORITY 9/ % 178/ % 187/ % IHA 47/ % 119/ % 166/ % WB: PHSA 90% Births 10/ % 260/ % 270/ % NICU: 85% VCHA 10/ % 246/ % 256/ % VIHA FHA 0/173-0% 83/ % 83/ % NHA 2/ % 126/ % 128/ % 142/ % 1738/ % 1880/ % HB/Out of Province Total Province NICU WELL BABY ALL BABIES TARGET 5.5 (8.2) - [5 14] HEALTH AUTHORITY FHA 6.0 (6.0) - [6.0] IHA Median Age (Mean Age) and [Range] of Unilateral Hearing Aid Fitting in Months 7.0 (7.0) - [7.0] NHA n/a WB: PHSA 90% NICU: 1.5 (1.5) - [1.5] VCHA 85% 3.0 (3.0) - [2 4] VIHA n/a HB/Out of Province 5.0 (5.3) - [1.5 14] Total Province 20

23 NICU WELL BABY ALL BABIES TARGET HEALTH AUTHORITY FHA Babies that Bypass Screening and Go Straight to Diagnostics IHA NHA WB: 90% PHSA NICU: 85% VCHA VIHA HB/Out of Province Total Province 21

24 2010 For more information on the BC Early Hearing Program visit our website at