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 4 th Quarterly Meeting, March 9, 2016
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 250 200 150 99% 100% 100% 100 50 0 13% Oct Nov Dec Total Births 225 207 206 Total Screened 222 207 206 Total FIS 28 14 18 7% 9%
SMBC Initial Screening Results 40 35 30 25 20 15 93% 94% 91% 10 5 0 0% 7% 9% Oct Nov Dec Total Births 30 31 35 Total Screened 28 29 32 Total FIS 0 2 3
GRMC Initial Screening Results 14 12 10 8 100% 100% 6 4 2 0% 0 Oct Nov Dec Total Births 0 10 12 Total Screened 0 10 12 Total FIS 0 0 1 8%
Initial Screening Totals 300 250 200 150 98% 99% 99% 100 50 11% 6% 0 Oct Nov Dec Total Births 255 248 253 Total Screened 249 247 250 Total FIS 28 14 21 8%
Sub AIMs 1. Increase accuracy of family contact information by 10%. 2. Decrease the number of refer of OAE by 10%.
Infants Referred by OAE and AABR Screener 250 200 150 100 50 22% 13% 17% 7% 9% 8% 0 Oct Nov Dec Total Screened 223 208 212 Total Referred by OAE 48 36 19 Total Referred by AABR Screener 28 14 18
Discussion and Input
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 GMH and GRMC and screened by GEIS) 30 25 20 15 10 5 7% 0% 0% 0 Oct Nov Dec Total Needing Rescreen 28 14 19 Total Rescreened 25 13 15 Total Relocating 3 0 0 Total Refuse Services 0 0 0 Total Pending 0 0 4 Total Lost to Follow Up 0 1 0
Outpatient Rescreen Totals (SMBC) 3.5 3 2.5 2 1.5 1 0.5 0% 0 Oct Nov Dec Total Needing Rescreen 0 2 3 Total Rescreened 2 3 Total Relocating 0 0 Total Refuse Services 0 0 Total Lost to Follow Up 0 0 0%
Sub AIMs 1. By April 2016, increase the number of children by 5% who receive the outpatient rescreens by 1 month. 2. By April 2016, increase the accuracy of family contact information by 5%
Outpatient Rescreen 30 25 20 15 79% 83% 10 72% 5 Total Needing Outpatient Rescreen Oct Nov Dec 28 14 23 Total Rescreened 25 13 19 Total Rescreened by 1 Month of Age 0 22 10 19
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 (Oct Dec 2015) 6 5 4 3 80% 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 Total LFU Series1 5 1 1 1 0 0 4 0 0%
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 1.2 1 0.8 0.6 0.4 0.2 0% 0% 0 Total with IFSP prior to 6 Total with Hearing Loss Total with IFSP months Series1 1 0 0
Sub AIMs 1. By December 2015, increase by 100% the monitoring services provided by GEIS to all infants pending a DAE. 2. By October 30, 2015, complete DAEs for 80% of all infants needing a DAE that were born from November 2014 April 2015.
DAE Data Total Total Children Born Nov 2014 Apr 2015 pending a DAE 10 Total Receiving a DAE 9 Note: 1 Family Refused services
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 10 9 8 7 6 5 4 3 2 1 0 0% 0% 0% Oct Nov Dec Total Needing Rescreen 9 9 6 Total Rescreened 5 7 3 Total Deceased 0 0 0 Total Relocating 0 0 2 Total Refuse Services 0 1 0 Total Pending 4 1 1 Total Lost to Follow Up 0 0 0
Sub AIMs 1. By April 2016, reduce number of no shows for high risk re screening appointments by 5%.
High Risk Rescreen QI Team Data Total Needing High Risk Rescreen Oct Nov Dec 9 9 6 Total Rescreened 4 7 3 Average Age at High Risk Rescreen 6.85 5.73 5.45
Training and Activities EVENT (December 2015 March 2016) RESULTS Prenatal classes GMH & SM Central DPHSS: 12/11/15(5);12/25/15(0, holiday); 01/08/16(9); 01/22/16(13); 02/12/16(10); 02/26/16(10) GMHA: 12/7/15(9); 01/04/16(11); 02/01/16(7) Outreach activities Hearing Screening Total: 74 participants 2/13: Head Start Fitness Fair 2/20: Check Me Out Fair 2/27: Dental Fair 3/4: GSAT Conference 3/19: GSAT Fair GEIS Hearing Screening Clinics 12/2 14, 12/22 15, 1/27 32, 2/25 25 3/30
Media Development
Media Development
Media Development
Media Development
Media Development Initial Screening The Guam EHDI project has maintained a 99% initial hearing screening rate at Guam Memorial Hospital Authority and Sagua Managu Birthing Facility. Percent Lost to Follow Up (LFU) Outpatient Rescreen High Risk Rescreen The Lost to Follow Up (LFU) rate for outpatient rescreens increased to 30% in 2012, and decreased to 27% in 2013. However, the rate decreased to 8% in 2014, which exceeded the established Guam EHDI benchmark. The Lost to Follow Up (LFU) rate for High Risk Rescreens increased to 33%in 2012, and 35% in 2013. In 2014, the Guam EHDI benchmark was met with 20% LFU for High Risk Rescreens. Diagnostic Audiological Evaluation (DAE)
Survey Results 1. Was the information provided helpful? Yes (9) or No ( 0 ) 2. Was the information Easy to understand? Yes (7) Yes Depending on target audience; very wordy for parents. No ( 0 ) May not be too parent friendly 3. Are there any changes to the format you would recommend? Yes or No (5) a. If yes, what would you recommend? Smaller Brochure Reduce the graphs; add a section that explains why we re pushing for the 1 3 6 time lines 4. Do you have any other suggestions? None at the moment None Concise/Shorter paragraphs or bullets Easier to read b/c it s wordy. Otherwise None. (1) A statement that F/U Screening is FREE (2) Add a picture(s) of infants actually being screened (3) Add a brief sections assuring parents that their babies aren t harmed by the process of hearing screening (4) Clarify what the follow up terms mean, so reader follows e.g., Initial Screening hearing screening at birth site before discharge, Outpatient Screening for follow up screening of the initial screening, High Risk Screening Child has history of risk factor at birth, but passed the initial screening 5. Would you prefer to have a printed or hard copy of the document or an electronic version? Hard Copy (5) or Electronic version (5) Thank you for taking the time in completing this form. Comments: Very Nice! Congrats for the Annual Report, well done, slick and glossy.
Closing Activities Open Discussion Announcements: Next Meeting: Wednesday, June 8, 2016