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Date and Duration: December 2022 – February 2024 (2 Years, 2 Months)

Early Hearing Detection and Intervention (EDHI) Initiative

Purpose

Early hearing detection is vital for newborns, as undiagnosed hearing loss can lead to delays in speech, language, vocalization, and social development. In Minnesota, while most infants are screened for hearing loss before one month of age, only 45.8% of those who failed their initial screening in 2020 received a diagnostic evaluation by three months. By addressing gaps in early hearing care, this initiative aims to increase the timeliness of hearing loss diagnosis and strengthen referral follow-up procedures.

EHDI Charter
References

1. Meyer AC, Marsolek M, Brown N, Coverstone K. Delayed Identification of Infants Who Are Deaf or Hard of Hearing – Minnesota, 2012-2016. Morbidity and Mortality Weekly Report (MMWR). 2020;69(11):303-306. doi:http://dx.doi.org/10.15585/mmwr.mm6911a6

2. National Center on Birth Defects and Developmental Disabilities, Center for Disease Control and Prevention. 2020 Summary of Infants Not Passing Hearing Screening Diagnosed Before 3 Months of Age.; 2023. https://www.cdc.gov/ncbddd/hearingloss/2020-data/07-diagnosed-by-3-months.html

Goals & Objectives

1. By October 2023 improve the Complete Audiological Hearing Evaluation (CAHE) of those 3 months or younger who were referred from newborn hearing screening by 25% or more

2. Improved care for newborns and family members

3. Improved coordination for timely diagnosis of infants who did not pass their newborn hearing screen

Among participating hospital teams, there was 4% improvement from baseline. Data from the Minnesota Department of Health (MDH) shows a 6% improvement in diagnosis related to hearing loss by 90 days for participating EDHI initiative teams.

How Success Is Tracked

A family of measures is a set of related metrics used in Quality Improvement (QI) initiatives to assess the overall impact, outcomes, and processes of a project. These measures provide a comprehensive picture of the initiative’s effectiveness and guide decision-making. A family of measures typically includes three types of metrics:

Outcome Measures

Definition: Metrics that reflect the ultimate goals or results of the initiative, focusing on the impact on patients, populations, or systems.
Purpose: To evaluate whether the initiative achieved its desired results.

Process Measures

Definition: Metrics that assess whether specific actions or interventions were implemented as intended. These focus on the steps or processes involved in achieving the outcome.
Purpose: To monitor the implementation and effectiveness of the processes driving the outcomes.

Balancing Measures

Definition: Metrics that ensure improvements in one area do not negatively affect other areas. They check for unintended consequences or trade-offs.
Purpose: To ensure that changes made to improve one outcome do not create new problems elsewhere.

Family Of Measures

Family of Measures

Outcome Measure (Data provide by Minnesota State)

1. Percentage of newborns screened

2. Percentage of newborns who did not pass newborn hearing screen and were rescreened within 15 days of discharge from birthing facility

3. Percentage of newborns, referred who received a complete audiological hearing evaluation by 3 months of age

Process Measure (Data collected by teams)

1. Percentage of families that had newborn hearing screen results and follow-up reviewed/discussed and documented (with hospital staff) prior to discharge

2. Percentage of newborns who did not pass newborn hearing screening and were scheduled for outpatient rescreen (within 15 days) prior to discharge

3. Percentage of newborns who did not pass hearing screening and were scheduled for audiological hearing evaluation within 6 weeks

4. Percentage of newborns with hearing screening results available at first newborn Primary Care Provider (PCP) visit regardless of reason for the first visit, e.g, weight check, bilirubin check

5. Percent of families where newborn hearing screen results and follow-up were reviewed/discussed and documented at first primary care clinic visit

6. Percentage of complete audiological hearing evaluation sent to MDH and PCP within six working days of evaluations

Balancing Measures (Data provided by Minnesota State)

1. Percentage of newborns lost to follow up

Toolkit

Our toolkits provide targeted resources specific to each QI program, offering essential materials to support healthcare teams in achieving improvement goals.

AAP- EHDI Provider Education Center
MDH- EHDI
MDH REFER Result- Hearing Screen Result Notification
MDH- Teach Back
MDH- Communicating REFER/Did Not Pass Results to Families

Reports

Early Hearing Detection and Intervention (EHDI) Initiative

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MNPQC’s Quality Improvement Programs were developed with support and guidance from hospital teams and professional faculty throughout the state of Minnesota. The contents do not necessarily represent the official views of, nor an endorsement, by MNPQC or our partners.