Reaching Out to Professionals: Workshop Development

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Reaching Out to ProfessionalsWorkshop
Development

• Amy Mirizzi, MPH
• Donna C. Maselli, RN, MPH
• Connecticut Department of Public Health
• Hartford, CT

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Faculty 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.

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Connecticut EHDI Program Components

• 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

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Newborn 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

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Identified 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

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Audiology Training

• Newborn Hearing Screening Symposium
• October 26, 2005

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Newborn Hearing Screening Symposium

• Target Audience
• Audiologists working with infants and children
• 16 diagnostic testing centers
• Co-sponsored with University of Connecticuts
  Department of Communication Sciences
• Approved ASHA CE Provider
• 0.6 CEUs (Advanced Level Professional Area)
• Full day conference

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Newborn Hearing Screening Symposium

• 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

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Speakers 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

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Agenda Continued

• 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 PCPs
• Role of the AAP PCP in EHDI

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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

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Agenda

• 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

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Evaluations

• 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

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Evaluation 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!

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Are there any topics that you would like to 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

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Outcomes from Hearing Symposium

• Recommendations for future trainings shared with
  University of CT for 2006 upcoming audiology
  training
• DPH staff conducting presentation on EHDI program
  to audiology students

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Hospital Training

• Public Health Initiatives for Newborns
• November 2, 2005

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Public 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.

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Speakers Agenda Topics

• DPH Breastfeeding Coordinator (WIC)
• DPH Breastfeeding Initiatives
• Programs 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

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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

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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

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Evaluation 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 years conference

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Suggestions

• Offer nursing CEUs for future conferences
• Open conference to other providers, such as
• Pediatricians
• Pediatric nurse practitioners
• PAs in pediatric offices

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Are there any topics that you would like to 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?)

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Are there any topics that you would like to 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)

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Are there any topics that you would like to 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

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Outcomes from Public Health Initiatives Conference

• Evidence of collaboration between various MCH
  programs within DPH
• Recommendations for future training needs
  identified and shared

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Summary

• 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