Guam Early Hearing Detection and Intervention Project Riko hi: Reducing Loss to Follow-Up after Failure to Pass Newborn Hearing Screening and at All Levels of the Hearing Continuum Quarterly Meeting, March 14, 2017
Welcome and Thank You for Coming
Agenda Sign In & Welcoming Call Meeting to Order Introduction of Members Approval of Minutes Progress update to the Aims and Sub-aims Open Discussion Announcements and Next Meeting
Outcomes After this meeting, Advisory members will provide input and recommendations to the following: Progress updates to the Aims and Sub-Aims; Provide feedback and recommendations
AIM 1 By March 31, 2017, Project Rikohi with participating birth site screeners will utilize specifically targeted and measurable interventions that are culturally and linguistically competent such as quality improvement methodologies in reducing the number of infants LTF/D who have not passed a newborn hearing screening examination prior to discharge from a birthing site to 1% or less
AIM 1 By March 31, 2017, Project Rikohi will reduce the number of infants LTF/D at initial screening to 1% or less. (about 2-3 per month)
GMHA Initial Screening Results 200 180 160 140 120 100 80 60 40 20 0 97% 96% 99% 16% 15% Oct Nov Dec Total Births 179 165 174 Total Screened 174 158 173 Total FIS 28 24 30 17%
SMBC Initial Screening Results 40 35 30 100% 25 20 100% 15 95% 10 5 5% 11% 5% 0 Oct Nov Dec Total Births 38 28 22 Total Screened 38 28 21 Total FIS 2 3 1
GRMC Initial Screening Results 60 50 40 98% 98% 30 100% 20 10 10% 5% 13% 0 Oct Nov Dec Total Births 51 37 47 Total Screened 50 37 46 Total FIS 5 2 6
Initial Screening Totals 300 250 200 150 98% 97% 99% 100 50 0 13% 13% Oct Nov Dec Total Births 268 230 243 Total Screened 262 223 240 Total FIS 35 29 37 15%
AIM 2 By March 31, 2017, Project Rikohi with participating birth site screeners and early intervention staff will utilize specifically targeted and measurable interventions that are culturally and linguistically competent such as quality improvement methodologies in reducing the number of infants LTF/D currently at 6% who did not pass the outpatient hearing screening by one month of age to 4% or less.
AIM 2 By March 31, 2017, Project Rikohi will reduce the number of infants LTF/D currently at outpatient rescreen to 4% or less. (about 1-2 per month)
Outpatient Rescreen Totals (Infants referred from GMHA and GRMC and screened by GEIS) 40 35 30 25 20 15 10 5 0 0% 0% Oct Nov Dec Total Needing Rescreen 33 26 36 Total Rescreened 29 23 25 Total Pending 3 2 10 Total Relocating 1 1 0 Total Refuse Services 0 0 0 Total Pending 0 0 0 Total Lost to Follow Up 0 0 1 3%
Outpatient Rescreen Totals (SMBC) 3.5 3 2.5 2 1.5 1 0.5 0 Oct Nov Dec Total Needing Rescreen 2 3 1 Total Rescreened 2 3 1 Total Pending 0 0 0 Total Relocating 0 0 0 Total Refuse Services 0 0 0 Total Lost to Follow Up 0 0 0 0%
AIM 3 By March 31, 2017, Project Rikohi with early intervention staff will continue to utilize specifically targeted and measurable interventions that are culturally and linguistically competent such as quality improvement methodologies in reducing the number of infants LTF/D for diagnostic audiological evaluation by 3 months of age from the aggregate 16% from 2011 to 2014 to 8% or less
AIM 3 By March 31, 2017, Project Rikohi will reduce the number of infants LTF/D for DAE to 8% or less. (about 1 per month)
Total Infants Referred for DAE (October December 2016) 8 7 6 5 86% 4 3 2 1 0 Total Infants Referred for DAE Total Infants Receiving DAE Total Infants Receiving DAE by 3 months Total with Hearing Loss Total Relocating Total Refusing Services Total Pending DAE Series1 7 0 0 0 0 1 6 0 0% Total LFU
AIM 5 By March 31, 2017, Project Rikohi with early intervention staff will continue to identify and utilize specifically targeted interventions such as CLC QI methodologies to ensure Individualized Family Service Plan (IFSP) are in place by six months of age for 100% of infant s identified with persistent and permanent hearing loss
AIM 5 By March 31, 2017, Project Rikohi will ensure Individualized Family Service Plan (IFSP) are in place by six months of age all infant s identified with hearing loss
Percent of Infants with HL receiving IFSP prior to 6 Months of Age There were no infants diagnosed with a HL this quarter
AIM 4 By March 31, 2017, Project Rikohi, with the medical home and early intervention staff, will continue to utilize specifically targeted and measurable interventions that are culturally and linguistically competent in reducing the number of infants LTF/D who have high risk factors for late onset and progressive hearing loss who fail to return for rescreen by six months of age from the current level of 20% to 10% or less
AIM 4 By March 31, 2017, Project Rikohi will reduce the number of infants LTF/D at the high risk rescreen level to 10% or less. (about 1-2 per month)
High Risk Rescreen 16 14 12 10 8 6 4 2 0 13% 0% Oct Nov Dec Total Needing Rescreen 8 14 12 Total Rescreened 5 6 9 Total Relocating 0 1 0 Total Refuse Services 0 2 0 Total Pending 2 5 3 Total Lost to Follow Up 1 0 0 0%
Update on High Risk LTFU QI effort 18 16 14 12 10 8 6 4 2 41% 35% 0 Total Infants listed as LTFU Total Contacted and Rescreened Refused Services Unresponsive Unable to locate or contact 17 7 1 3 6
Guam EHDI Hearing Screening Clinics 9/16, 10/28, 11/21, 1/23, 2/13, 3/24 (scheduled) Training and Activities EVENT (October 2016 March 2017) Prenatal classes GMH & DPHSS RESULTS Central DPHSS: September 9 & 23, 2016 (29); October 14 &28, 2016 (33); November 11 (cancelled), November 25, 2016 (14); December 9 (cancelled); December 23, 2016 (11); January 13 (13); January 27, 2017 (cancelled); February 10 (9); February 24, 2017 (cancelled); March 10, 2017 (13) final presentation. GMHA: September 12, 2016 (14); October 3, 2016 (5); November 7, 2016 (15); December 5, 2016 (7); January 9, 2017 (28); February 6, 2017 (4) final presentation. Total: 229 participants Outreach activities Hearing Screening 10/29 Health Mothers, Healthy Babies (Ambros 1/7 Health Mothers, Healthy Babies (DPHSS) 2/11 Head Start Fitness Fair; 3/4 GSAT Fair GEIS Hearing Screening Clinics 9/28, 10/31, 11/30, 12/28, 1/4, 1/17,2/23, 3/28 (scheduled)
System Sustainability Current overall status
New HRSA Grant Application Overall Program Goal: To support the development of a statewide program and system of care that ensures that deaf or hard of hearing children are identified through newborn and infant hearing screening and receive evaluation, diagnosis, and appropriate intervention that optimize their language, literacy, and socialemotional development.
New HRSA Grant Application Program goals are: 1: Increase health professionals engagement within and knowledge of the EHDI system; 2: Improve access to early intervention services and language acquisition; and 3: Improve family engagement, partnership, and leadership within the EHDI programs and systems.
New CDC Grant Application Program Strategies: By June 2020, the end of the three-year project period: 1) Surveillance to implement a complete EHDI-IS. 2) Training and support to provide training and technical assistance to address the needs of state partners involved in the EHDI reporting processes. 3) Partnership to promote and support coordination and collaboration around capturing data. 4) Communication and dissemination to support targeted dissemination of data and information among stakeholders. 5) Monitoring, analysis and evaluation to maintain data quality and guide programmatic improvement.
Next Steps Bylaws Update
Closing Activities Open Discussion Announcements: Next Meeting: June 13, 2017