Embed Size (px)
Citation preview
J E A N E T T E D . J E A N E T T E D . J E A N E T T E D . J E A N E T T E D . W E B BW E B BW E B BW E B B , , , , M . E DM . E DM . E DM . E D
W E N D YW E N D YW E N D YW E N D Y A . A . A . A . J U M O N V I L L EJ U M O N V I L L EJ U M O N V I L L EJ U M O N V I L L E , , , , M . S . , C C CM . S . , C C CM . S . , C C CM . S . , C C C ---- AAAA
LA EHDI DEFINITION OF IN PROCESS
�Failed newborn hearing screeningFailed newborn hearing screeningFailed newborn hearing screeningFailed newborn hearing screening
�Had at least 1 followHad at least 1 followHad at least 1 followHad at least 1 follow----up service w/ up service w/ up service w/ up service w/
inconclusive resultsinconclusive resultsinconclusive resultsinconclusive results
�No documentation of LTFNo documentation of LTFNo documentation of LTFNo documentation of LTF
�6 6 6 6 ---- 9% average for 2010 9% average for 2010 9% average for 2010 9% average for 2010 –––– 2014 (2014 (2014 (2014 (QtrsQtrsQtrsQtrs 1&2)1&2)1&2)1&2)
2 CATEGORIES OF IN PROCESS
� Referral to 2Referral to 2Referral to 2Referral to 2ndndndnd facilityfacilityfacilityfacility
� Rescheduled at same facilityRescheduled at same facilityRescheduled at same facilityRescheduled at same facility
REFERRAL TO 2ND FACILITY
�AudiologistsAudiologistsAudiologistsAudiologists
�PCPsPCPsPCPsPCPs
�FamiliesFamiliesFamiliesFamilies
PLAN:PLAN:PLAN:PLAN: Review Review Review Review every every every every
FSR where FSR where FSR where FSR where
infant infant infant infant was was was was
referred referred referred referred to a to a to a to a
2222ndndndnd facility facility facility facility
D0: D0: D0: D0:
Sent 15 Sent 15 Sent 15 Sent 15
faxes to faxes to faxes to faxes to
aaaaudiologists udiologists udiologists udiologists
at 2at 2at 2at 2ndndndnd facilityfacilityfacilityfacility
PDSA #1 - AUDIOLOGIST
Had FUHad FUHad FUHad FU61%61%61%61%
No FUNo FUNo FUNo FU39%39%39%39%
n n n n = 64= 64= 64= 64
STUDYSTUDYSTUDYSTUDY
2222
3333
7777
3333
0000
1111
2222
3333
4444
5555
6666
7777
8888
No ResponseNo ResponseNo ResponseNo Response ResultsResultsResultsResultsReceivedReceivedReceivedReceived
ReferralReferralReferralReferralNeverNeverNeverNever
ReceivedReceivedReceivedReceived2nd Facility2nd Facility2nd Facility2nd Facility
Reported LTFReported LTFReported LTFReported LTF
#
#
#
# B
abie
s
n =15n =15n =15n =15
No Response = 13%No Response = 13%No Response = 13%No Response = 13%
ResponseResponseResponseResponse
Received = 87%Received = 87%Received = 87%Received = 87%
ACTACTACTACT
� Adopt Adopt Adopt Adopt –––– SpreadSpreadSpreadSpread
� Assisting both referral Assisting both referral Assisting both referral Assisting both referral and receiving and receiving and receiving and receiving
facilities in establishing protocol facilities in establishing protocol facilities in establishing protocol facilities in establishing protocol
� Sustainability Sustainability Sustainability Sustainability –––– working with working with working with working with
audiologists who audiologists who audiologists who audiologists who fail to report fail to report fail to report fail to report –––– Lost to Lost to Lost to Lost to
DocumentationDocumentationDocumentationDocumentation
PDSA #2 - PCP
PLAN: PLAN: PLAN: PLAN: Review Review Review Review every FSR where every FSR where every FSR where every FSR where
infant infant infant infant was referred to a 2was referred to a 2was referred to a 2was referred to a 2ndndndnd
facility facility facility facility
DO: DO: DO: DO: 10 10 10 10 faxes sent to faxes sent to faxes sent to faxes sent to PCPPCPPCPPCP
STUDYSTUDYSTUDYSTUDY
0
1
2
3
4
5
6
No Response Results Received Not My Patient Will Ensure FU
ACTACTACTACT
� Adapt Adapt Adapt Adapt –––– repeat with repeat with repeat with repeat with
adjustments on FAX form and adjustments on FAX form and adjustments on FAX form and adjustments on FAX form and
check check check check resultsresultsresultsresults
� PCP education & awarenessPCP education & awarenessPCP education & awarenessPCP education & awareness
PDSA - FAMILIES ???
�AbandonedAbandonedAbandonedAbandoned�Based on results with “Families: In Based on results with “Families: In Based on results with “Families: In Based on results with “Families: In Process with Same FacilityProcess with Same FacilityProcess with Same FacilityProcess with Same Facility” PDSAPDSAPDSAPDSA
�Best results obtained with Best results obtained with Best results obtained with Best results obtained with Audiologist PDSA strategyAudiologist PDSA strategyAudiologist PDSA strategyAudiologist PDSA strategy
IN PROCESS IN PROCESS IN PROCESS IN PROCESS
WITHIN SAME FACILITYWITHIN SAME FACILITYWITHIN SAME FACILITYWITHIN SAME FACILITY
�Audiologists
�Families
PDSA #3 - AUDIOLOGIST
CYCLE 1CYCLE 1CYCLE 1CYCLE 1
PLANPLANPLANPLAN: : : : Review Review Review Review In In In In Process list for Process list for Process list for Process list for January January January January to to to to June 2014 birthsJune 2014 birthsJune 2014 birthsJune 2014 births
DO: DO: DO: DO: Fax Fax Fax Fax to to to to 2 2 2 2 aaaaudiologists of udiologists of udiologists of udiologists of last last last last report requesting updated report requesting updated report requesting updated report requesting updated statusstatusstatusstatus
STUDY:STUDY:STUDY:STUDY:
1 of 2 audiologists 1 of 2 audiologists 1 of 2 audiologists 1 of 2 audiologists
respondedrespondedrespondedresponded
1111
44444444
n=9n=9n=9n=9
Confirmed Confirmed Confirmed ConfirmedStatusStatusStatusStatus
Reported Reported Reported ReportedLTFLTFLTFLTF
No No No NoResponseResponseResponseResponse
ACT:ACT:ACT:ACT:
� AAAAdapt dapt dapt dapt
� SSSSpread pread pread pread to 2 to 2 to 2 to 2 additional audiologists additional audiologists additional audiologists additional audiologists
� Fax Fax Fax Fax sent by sent by sent by sent by LA EHDI AudiologistLA EHDI AudiologistLA EHDI AudiologistLA EHDI Audiologist
� Fax vs. Fax vs. Fax vs. Fax vs. email email email email scansscansscansscans
� Move to Cycle 2Move to Cycle 2Move to Cycle 2Move to Cycle 2
CYCLE 2CYCLE 2CYCLE 2CYCLE 2
PLAN: PLAN: PLAN: PLAN: Review Review Review Review In In In In Process list for Process list for Process list for Process list for January January January January to to to to June 2014 birthsJune 2014 birthsJune 2014 birthsJune 2014 births
DO: DO: DO: DO: LA EHDI audiologist sent faxes LA EHDI audiologist sent faxes LA EHDI audiologist sent faxes LA EHDI audiologist sent faxes & email scans to 2 & email scans to 2 & email scans to 2 & email scans to 2 aaaaudiologistsudiologistsudiologistsudiologistsof of of of last last last last report requesting report requesting report requesting report requesting updated statusupdated statusupdated statusupdated status
STUDY: STUDY: STUDY: STUDY:
2 of 2 2 of 2 2 of 2 2 of 2
audiologists audiologists audiologists audiologists
respondedrespondedrespondedresponded2222
22224444
nnnn = = = = 8888
Will Will Will Willcontactcontactcontactcontactfamilyfamilyfamilyfamily
Confirmed Confirmed Confirmed ConfirmedHearingHearingHearingHearingStatusStatusStatusStatus
Reported Reported Reported ReportedLTFLTFLTFLTF
ACT:ACT:ACT:ACT:
� AdaptAdaptAdaptAdapt
� Retest with increase in infants Retest with increase in infants Retest with increase in infants Retest with increase in infants
and number of audiologistsand number of audiologistsand number of audiologistsand number of audiologists
� Move to Cycle 3Move to Cycle 3Move to Cycle 3Move to Cycle 3
CYCLE 3CYCLE 3CYCLE 3CYCLE 3
PLAN: PLAN: PLAN: PLAN: Review Review Review Review In In In In Process list for Process list for Process list for Process list for January January January January to to to to June 2014 birthsJune 2014 birthsJune 2014 birthsJune 2014 births
DODODODO: : : : LA EHDI audiologist sent faxes LA EHDI audiologist sent faxes LA EHDI audiologist sent faxes LA EHDI audiologist sent faxes & email scans to 4 audiologists& email scans to 4 audiologists& email scans to 4 audiologists& email scans to 4 audiologistsof of of of last last last last report requesting report requesting report requesting report requesting updated statusupdated statusupdated statusupdated status
4 of 4 4 of 4 4 of 4 4 of 4
audiologists audiologists audiologists audiologists
respondedrespondedrespondedresponded
11112222
20202020
1111
n n n n = 24= 24= 24= 24
Will ContactWill ContactWill ContactWill ContactFamilyFamilyFamilyFamily
ConfirmedConfirmedConfirmedConfirmedHearing StatusHearing StatusHearing StatusHearing Status
Reported LTFReported LTFReported LTFReported LTF
In ProcessIn ProcessIn ProcessIn Process
STUDYSTUDYSTUDYSTUDY
ACTACTACTACT
Adopt and SpreadAdopt and SpreadAdopt and SpreadAdopt and Spread
PDSA #4 PDSA #4 PDSA #4 PDSA #4 ---- FAMILY FAMILY FAMILY FAMILY (same facility)(same facility)(same facility)(same facility)
PLAN: PLAN: PLAN: PLAN: Review Review Review Review In In In In Process list for Process list for Process list for Process list for January January January January to to to to June 2014 June 2014 June 2014 June 2014 birthsbirthsbirthsbirths
Select 10 babies “in process”Select 10 babies “in process”Select 10 babies “in process”Select 10 babies “in process”
CYCLE 1
DO: DO: DO: DO: Contact 10 families by phoneContact 10 families by phoneContact 10 families by phoneContact 10 families by phone
� Obtain feedback about the processObtain feedback about the processObtain feedback about the processObtain feedback about the process
� Had followHad followHad followHad follow----up & not reported?up & not reported?up & not reported?up & not reported?
� Confirm status with audiologist based Confirm status with audiologist based Confirm status with audiologist based Confirm status with audiologist based
on parent reporton parent reporton parent reporton parent report
CYCLE 1
5555
3333
2222
nnnn = = = = 10101010
Unable to ContactUnable to ContactUnable to ContactUnable to Contact
Successful ContactSuccessful ContactSuccessful ContactSuccessful Contact
Left Message - NRLeft Message - NRLeft Message - NRLeft Message - NR
� Successful Contact = 3Successful Contact = 3Successful Contact = 3Successful Contact = 3
� Parent will schedule appointment
� Recently had follow-up - P/P (LTD)
� Has diagnosed HL – LTD
� Unable to Contact or Message NR = 7Unable to Contact or Message NR = 7Unable to Contact or Message NR = 7Unable to Contact or Message NR = 7� Called audiologist for updated status
2 P/P (LTD)
5 LTF reports requested
CYCLE 1
ACTACTACTACT AbandonAbandonAbandonAbandon
Next?Next?Next?Next?
�Test same strategy but more timely
from last reported follow-up service
�Questions to ask family for anecdotal
feedback
RESULTS OVERALL
7.7%7.7%7.7%7.7%
4.9%4.9%4.9%4.9%
1.9%1.9%1.9%1.9%
0.0%
1.0%
2.0%
3.0%
4.0%
5.0%
6.0%
7.0%
8.0%
9.0%
2013201320132013 Pre PDSAs*Pre PDSAs*Pre PDSAs*Pre PDSAs* Post PDSAs*Post PDSAs*Post PDSAs*Post PDSAs*
*Births*Births*Births*Births
Jan Jan Jan Jan –––– June 2014June 2014June 2014June 2014
WWWWhat have we learned hat have we learned hat have we learned hat have we learned from from from from testing testing testing testing these strategies?these strategies?these strategies?these strategies?
What advice would What advice would What advice would What advice would we we we we give to other give to other give to other give to other states who want to test states who want to test states who want to test states who want to test these these these these
strategies?strategies?strategies?strategies?
SustainabilitySustainabilitySustainabilitySustainability????
Wendy A. JumonvilleWendy A. JumonvilleWendy A. JumonvilleWendy A. Jumonville
Outreach SpecialistOutreach SpecialistOutreach SpecialistOutreach Specialist
[email protected]@[email protected]@la.gov
Jeanette D. WebbJeanette D. WebbJeanette D. WebbJeanette D. Webb
FollowFollowFollowFollow----Up CoordinatorUp CoordinatorUp CoordinatorUp Coordinator
[email protected]@[email protected]@la.gov
QUESTIONS
