19th ANNUAL EARLY HEARING DETECTION & INTERVENTION MEETING
March 8-10, 2020 • Kansas City, MO
Navigating care pathways to “1-3-6” goals in the NICU
Newborn hearing screening program guidance has maintained a “1-3-6” goal to screen by one month of age, have a diagnosis by three months of age, and implement early intervention no later than six months of age. While there is always room for improvement, individual hospitals and statewide EHDI programs have improved approaches over the years making 1-3-6 a reasonable and attainable goal for most newborns/infants and their families. Challenges persist in the Neonatal Intensive Care Unit (NICU) setting where separate protocols and techniques from the well-baby nursery are recommended. Particularly for newborns in the NICU that have multiple risk factors and comorbidities, it may not be medically feasible to screen their hearing by one month of age. In 2018 in Minnesota, 98% of babies with normal birth weight were screened by one month versus 47% of babies with low birth weight (many NICU patients fall into this category). When we review the NICU patient population’s journey through hearing screening, diagnosis and intervention, we often find that traditional 1-3-6 targets are not met. Some states use corrected age when looking at these benchmarks, but the Centers for Disease Control (CDC) and Minnesota Department of Health (MDH) do not. Furthermore, limited guidance for “medically feasible” as well as long-term monitoring of patients in the NICU exists. In our institution, we maintain the intention to meet these 1-3-6 goals with the understanding that in individual cases we need to prioritize the needs of the patients resulting in adapting 1-3-6 targets. Here we will share outcomes of our programmatic review of hearing screenings in the NICU for over 20 years as well as provide case illustrations to highlight different care pathways. Discussion will focus on best practice recommendations in the NICU setting as well as considerations for continued programmatic development.
- 1. Promote awareness of the challenges and opportunities facing achievement of the 1-3-6 goals in the NICU setting
- 2. Discuss the importance of evaluating current protocols and identifying opportunities for quality improvement of care models in the inpatient portion of a hearing screening program.
- 3. Illustrate various care pathways to screening, diagnosis, and early intervention goals in the NICU population.
Poster:
21060_12696JoscelynMartin.pdf
Presenter: Joscelyn Martin
Joscelyn R.K. Martin, Au.D. is a pediatric audiologist at the Mayo Clinic in Rochester, Minnesota. She holds Pediatric Audiology Specialty Certification (PASC) from the American Board of Audiology. Dr. Martin has been coordinator of the Mayo Clinic Early Hearing Detection and Intervention (EHDI) program since its inception in 1999. In addition to early intervention for children with hearing loss, she is passionate about child and family centered counseling and the positive impact it has on the diagnostic and re/habilitative process for the families with whom she works.
ASHA DISCLOSURE:
Financial -
No relevant financial relationship exist.
Nonfinancial -
No relevant nonfinancial relationship exist.
Kaitlyn Caceres, Au.D. works as a pediatric audiologist at the Mayo Clinic in Rochester, Minnesota. She obtained her Au.D. at the University of Wisconsin-Madison. She has a passion for working with children with complex health needs and their families.
ASHA DISCLOSURE:
Financial -
• Receives Salary for Employment from Mayo Clinic.
Nonfinancial -
No relevant nonfinancial relationship exist.
Rachel Amorim has been a clinical Audiologist for 21 years . She received her B.S. and M.A. from the University of Minnesota and her Au.D. from the University of Florida. She has been with Mayo Clinic for over 17 years and her primary interest is diagnostics across the life span. She evaluates patients in both an outpatient clinic based setting as well as hospital based setting including the NICU.
ASHA DISCLOSURE:
Financial -
Nonfinancial -
Amy Olund, Au.D., is an audiologist at Mayo Clinic in Rochester, MN. She received her Au.D. from the University of Minnesota in 2010. Her clinical and research interests include evoked potentials and implantable devices. She has acted as a co-investigator in six FDA clinical trials and has co-authored two publications exploring new indications and expanded criteria for cochlear implantation.
ASHA DISCLOSURE:
Financial -
Nonfinancial -
Gayla L. Poling, Ph.D. is the Director of Diagnostic Audiology Research at Mayo Clinic, Rochester, MN. She is an Assistant Professor of Audiology, Mayo Clinic College of Medicine. She studied Audiology and Hearing Sciences at The Ohio State University and completed postdoctoral fellowships at the Medical University of South Carolina and Northwestern University. Her primary interest is auditory diagnostics with her research focused on early detection and prevention of hearing loss across the life course.
ASHA DISCLOSURE:
Financial -
No relevant financial relationship exist.
Nonfinancial -
No relevant nonfinancial relationship exist.