2023 Early Hearing Detection & Intervention Conference

March 5-7, 2023 • Cincinnati, OH

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3/20/2018  |   9:40 AM - 10:40 AM   |  Practice-based Quality Improvement in Early Hearing Detection and Intervention (EHDI)   |  Quartz A/B

Practice-based Quality Improvement in Early Hearing Detection and Intervention (EHDI)

The Early Hearing Detection and Intervention (EHDI) program at the American Academy of Pediatrics (AAP) is dedicated to strengthening and promoting the role of the medical home and the primary care provider within the EHDI system to ensure that children and families receive appropriate and timely assessment, intervention, and support. Through a national Quality Improvement (QI) collaborative, the AAP EHDI program planned and implemented a 2-phase QI project aimed at developing practice-based improvements that enhance care across the delivery system. This QI project used the Institute for Healthcare Improvement (IHI) Model for Improvement to incorporate small tests of change (Plan, Do, Study, Act cycles) to impact pediatrician knowledge and practice changes that increased rates of documentation of newborn hearing screening results, conversations with families regarding results, managing referrals for audiologic diagnostic evaluation, comprehensive assessment of risk factors for late-onset hearing loss, enrollment into early intervention, tracking and surveillance, data management, and ongoing communication with families. These structured processes and changes helped teams make improvements to electronic health record systems, internal workflow patterns, and parent engagement techniques. During Phase 2, each practice team was required to engage a Parent Partner who provided family perspective and offered insight and feedback about changes and the development of informational materials. Final project data and results indicate success regarding measures around tracking risk-factor assessment, documentation of diagnostic results, and documentation of family conversations about test outcomes and next steps for care. Project interventions included parent interviews to identify gaps in EHDI processes, an in-person educational learning session, a change package with tools/resources, monthly educational webinars, QI coaching calls, and ongoing support from an expert group. A comprehensive toolkit including samples/templates for each of the tools/resources used throughout this project is available for customization and use.

  • • Describe and apply the IHI Model for Improvement model as an effective framework for process improvement.
  • • Describe specific practice-based improvements that impacted implementation of Joint Childhood and Infant Hearing guidelines in practice to strengthen the role of the medical home within the EHDI system.
  • • Identify systems and processes that improved rates of documentation regarding results and conversations, streamlined referrals and consistent follow-up with both families and other care providers.

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Presenters/Authors

Susan Wiley (), Cincinnati Children's Hospital Medical Center, susan.wiley@cchmc.org;
Dr. Susan Wiley is a developmental pediatrician with extensive expertise in children who are deaf/hard of hearing. She has many years of experience serving children with multiple disabilities. Dr Wiley provides leadership and guidance to the National American Academy of Pediatrics, the Ohio Department of Health Early Hearing Detection and Intervention Program, the Ohio Center for Deaf-Blind Education, and the Outreach Center for Deafness and Blindness in the Ohio Center for Low Incidence.


ASHA DISCLOSURE:

Financial -
No relevant financial relationship exist.

Nonfinancial -
No relevant nonfinancial relationship exist.

Leslie Lestz (), Centennial Pediatrics, lklestz@gmail.com;
Dr. Leslie Katz Lestz graduated cum laude from Harvard University with a degree in English and American Literature. She received her MD in 1998 at Emory University School of Medicine. She completed her Pediatric residency at Children's Medical Center of Dallas in 2001. She is currently a practicing Pediatrician at Centennial Pediatrics in Little Elm, Texas. Dr. Lestz accepted an appointment from the American Academy of Pediatrics in February 2014 to serve as the AAP Chapter Champion for the EHDI program for Texas. In addition, she serves on several state committees through the Texas Department of State Health Services including the Deaf and Hard of Hearing Leadership Council and the Medical Home Workgroup. She lives in Dallas, TX with her husband and 3 children, ages 14, 12 and 9. Two of her children are hard of hearing and Dr. Lestz was also diagnosed with a bilateral mild hearing loss last year.


ASHA DISCLOSURE:

Financial -

Nonfinancial -

Sandi Ring (), American Academy of Pediatrics, sring@aap.org;
Sandi Ring is the Early Hearing Detection and Intervention (EHDI) Program Manager at the American Academy of Pediatrics (AAP). In this role, Ms Ring is the primary contact for state Chapter Champions, acts as staff liaison to the AAP EHDI Leadership Team, and is working to expand relationships with organizations that support all members of the Deaf and Hard of Hearing community. Primary projects include oversight of national, state, and local EHDI initiatives including provision of tools and resources to pediatric primary care clinicians, educational support and guidance, and oversight of quality improvement initiatives. Prior to employment with the American Academy of Pediatrics, Ms Ring served as Senior Manager of Medical Eligibility and Outreach for Make-A-Wish America. She has a Masters in Early Childhood Development from the Erikson Institute, is a Certified Child Life Specialist, and has vast experience in program management, healthcare outreach and education initiatives, and collaborative partnership development.


ASHA DISCLOSURE:

Financial -

Nonfinancial -