Reaching Out to Professionals:Reaching Out to Professionals:Workshop DevelopmentWorkshop Development

Amy Mirizzi, MPH

Donna C. Maselli, RN, MPH

Connecticut Department of Public Health

Hartford, CT

Faculty Disclosure InformationFaculty Disclosure Information

In the past 12 months, I have not had a significant financial interest or other relationship with the manufacturer(s) of the product(s) or provider(s) of the service(s) that will be discussed in my presentation.

This presentation will not include discussion of pharmaceuticals or devices that have not been approved by the FDA.

Connecticut EHDI Program Connecticut EHDI Program ComponentsComponents

Department of Public Health – Lead agency for universal newborn hearing screening program– Program development– Tracking & follow-up– Education

Diagnostic Testing Centers– Performs diagnostic test battery– Refers infants to E.I.– Reports to DPH

CT Birth-to-Three System– Lead agency for IDEA, Part C

Newborn Hearing Screening Task ForceNewborn Hearing Screening Task Force

Meets monthly to discuss issues surrounding EHDI

Interdisciplinary members representative of:– Diagnostic Testing Centers (Audiologists), ENT, Family, Deaf

Counselor, Deaf Educator, Hospital Staff, DPH and others from state political and government agencies

Role– Developed ‘Best Practice Standards for Infant Diagnostic Testing’– Assists with the development of educational materials– Participates in trainings of health care providers– Provides technical expertise as needed– Assists in planning and quality improvement

Identified Need for TrainingsIdentified Need for Trainings

Target Audiences– Audiologists (Diagnostic Testing Centers)– Birth Hospital staff

Needs assessment– MCHB UNHS new grant initiatives– Task Force members experience in the field– DPH tracking & lost to follow-up rates– Communication with 16 diagnostic testing centers

Audiology TrainingAudiology Training

Newborn Hearing Screening Symposium

October 26, 2005

Newborn Hearing Screening SymposiumNewborn Hearing Screening Symposium

Target Audience– Audiologists working with infants and children– 16 diagnostic testing centers

Co-sponsored with University of Connecticut’s Department of Communication Sciences– Approved ASHA CE Provider– 0.6 CEUs (Advanced Level: Professional Area)

Full day conference

Objectives:– To increase awareness of appropriate diagnostic

procedures and early intervention services.– To enhance knowledge of current topics and

initiatives related to childhood hearing loss.– To increase knowledge of medical issues related to

congenital, early onset, and progressive hearing loss

– To facilitate prompt and accurate diagnosis of hearing loss and referral to EI

Newborn Hearing Screening SymposiumNewborn Hearing Screening Symposium

Speakers & Agenda TopicsSpeakers & Agenda Topics

Pediatric Audiologist– The Diagnostic Evaluation

Various dx tests and equipment Task Force recommended battery of tests Tips on how to improve technique

Pediatric Audiologists– Case Studies in the Diagnostic Process

Learn from shared experiences

Otolaryngologist– The ENT Evaluation

Geneticist– Benefits of Genetic Testing/When Referrals to Other

Specialists are Indicated Statistics related to genetics and hearing loss Genetic testing Syndromic versus non-syndromic hearing loss Inheritance patterns Case Studies Referrals to other Specialists

CT AAP Chapter Champion– Connecting with the Primary Care Provider

Resources for PCP’s Role of the AAP & PCP in EHDI

Agenda Continued…Agenda Continued…

Agenda…Agenda…

DPH EHDI Staff– Past, Present, and Future Initiatives

Program overview Statistics Results of PCP survey Reporting to DPH Study results “The Lack of EI on Infants with Hearing Loss”

NE Regional MCHB EHDI Audiologist– Risk Factors for Hearing Loss

JCIH Risk indicators Importance of timely and appropriate diagnosis of hearing loss Principles and issues of early intervention and follow-up

State Department of Education Representative– Services for Children with Hearing Loss in the School

System State education statistics related to children with special health

care needs Education-related mandates and policies IEP vs. IFSP Section 504 of the Rehabilitation Act

Agenda…Agenda…

EvaluationsEvaluations

Feedback on whether participants felt…– Objectives were met– Information presented was educational– Presenters were effective– Materials were relevant– Location and meeting space were convenient

and functional

Evaluation CommentsEvaluation Comments

Excellent Symposium Very informative and worthwhile Excellent! Very comprehensive & useful information Very informative day with excellent speakers Excellent range of topics within the larger ‘Hearing

Impairment’ theme AAP Web slides difficult to read in handout Nice job!

Are there any topics that you would like to Are there any topics that you would like to see additional training on?see additional training on?

Would like more training on actual testing procedures: problems, pitfalls, how to overcome these. In talking to a number of the persons in the diagnostic centers, some do not see high volumes of children and do not feel comfortable with diagnosing. More training might reduce the diagnosis time (increase age at diagnosis).

ASSR vs. ABR

Outcomes from Hearing Outcomes from Hearing SymposiumSymposium

Recommendations for future trainings shared with University of CT for 2006 upcoming audiology training

DPH staff conducting presentation on EHDI program to audiology students

Hospital TrainingHospital Training

Public Health Initiatives for Newborns

November 2, 2005

Public Health Initiatives for NewbornsPublic Health Initiatives for Newborns

Target Audience– Hospital staff

Well baby nursery and NICU Nurse Managers and nurses Hospital hearing screening staff

Objectives:– To enhance knowledge of current public health

initiatives for newborns.– To reinforce newborn screening purposes, techniques,

and reporting practices and requirements, including the importance of monitoring and follow-up of at risk infants.

Speakers & Agenda TopicsSpeakers & Agenda Topics

DPH Breastfeeding Coordinator (WIC)– DPH Breastfeeding Initiatives

Program’s past, present, and future initiatives Data reporting and collection Breastfeeding rates by hospital

Medical Director of Cystic Fibrosis Screening Program– Newborn Screening for Cystic Fibrosis

Disease description, including signs and symptoms Screening rationale and statistics Benefits of universal screening and early identification

Agenda continued…Agenda continued…

DPH– The Connecticut Immunization Registry &

Tracking System History of immunizations in CT Parental consent to be in the registry Overview and benefits for pediatric practices, parents, and

public health Compliance & incentives to increase reporting

Agenda…Agenda…

Newborn Hearing Screening Program– Data Reporting

Enhancements to the internet based reporting system

– Newborn Screening: Past, Present, & Future Initiatives Review of screening, diagnostic, and early intervention process Genetic components Laboratory NBS and Birth Defects Registry PCP & family survey results Screening methods for NICU babies

Early Intervention Specialty Center Audiologist– Risk Indicators and the Importance of Follow-Up Monitoring

Congenital, early onset, and progressive hearing loss Validate parental concern

Evaluation CommentsEvaluation Comments Very good review and chance to ask questions, clarify expectations,

and enhance practice at hospital level Very interesting, informative conference – relevant to our practice.

Provided combination of new information and reinforcement of current process for NBS – will bring information back to staff

Too much for afternoon session Enjoyed questions, interactive component “Risk indicators” basically review of earlier speaker Appreciated the positive feedback about our efforts in screening Vents were loud and made it difficult to hear questions/comments

from audience Positive feedback regarding sharing information through case studies Looking forward to next year’s conference

SuggestionsSuggestions

Offer nursing CEUs for future conferences Open conference to other providers, such as:

Pediatricians Pediatric nurse practitioners PAs in pediatric offices

Are there any topics that you would like to Are there any topics that you would like to see additional training on?see additional training on?

Hearing Screening: – More info/education about Birth-to-Three (EI), so we can

better refer and describe service to our parents– Is there information about hearing and speech in the rainbow

packet? (i.e. milestones for parents to watch for?)

Are there any topics that you would like to Are there any topics that you would like to see additional training on?see additional training on?

Lab Screening:– How to talk to parents about uncertain diagnoses (already aware of

fact sheets)– PKU “rules” – a map or flow diagram (i.e. if transfused – do this in

“x” time period)– Information on blood specimen collection– A talk offering guidance as to expected follow up (as far as repeating

NBS heelstick specimens, immediate repeat vs. before discharge, etc.)

Immunization Registry:– More information about entering data into the Immunization Registry

in the case of infants hospitalized for 9-12 months after birth (and thus receiving their immunizations as an inpatient)

Are there any topics that you would like to Are there any topics that you would like to see additional training on?see additional training on?

Other:– Follow up on HIV initiatives since implementation of mandatory

testing– Continued updates are great (keep current without repeating old

information)– Orientation session for new people in hospitals to reporting

system and Electronic Vital records System (EVRS) – who will be responsible for data entry

– Car seat safety laws

Outcomes from Public Health Outcomes from Public Health Initiatives ConferenceInitiatives Conference

Evidence of collaboration between various MCH programs within DPH

Recommendations for future training needs identified and shared

SummarySummary

Trainings provided positive benefits for– Participants

Networking opportunity Opportunities to learn from others, develop ideas, ask

questions

– DPH Show appreciation for participants dedication to newborns Share protocol changes and new incentives Highlight DPH initiatives Identify topics for future trainings