Title: 'Using EHDI topics for Medical Home Quality Improvement and Pediatric Maintenance of Certification'
Track: 5 - Medical Home
Keyword(s): medical home, quality improvement, maintenance of certification
Learning Objectives:
  1. develop quality improvement and maintenance of certification activities related to EHDI for pediatric providers
  2. use data driven QI measures to assess monitoring of infants for hearing loss risk factors
  3. implement a coaching program that engages pedaitricians in improving practice follow up for newborns diagnosed with hearing loss and contributing to statewide EHDI goals


The pediatric medical home is critical in the care of children with, or at risk for, hearing loss. Because hearing loss is a low incidence condition, engaging pediatric primary care sites in improving care for children with, or at risk for, hearing loss can be challenging. The American Board of Pediatrics (ABP) requires that pediatricians participate in practice-based quality improvement (QI) initiatives in order to maintain certification. With approval from the ABP, Connecticut and Iowa have developed innovative QI activities that can improve care for children with, or at risk for, hearing loss and provide pediatricians with certification credits. The Children and Youth with Special Health Care Needs program in Iowa designed a QI activity for pediatricians and family physicians. Staff train providers to monitor newborns that passed their newborn hearing screening but have risk factors for late onset or progressive hearing loss as outlined in the Joint Committee on Infant Hearing Guidelines. Participating providers complete monthly data entry on children with risk factors for the 18, 24 and 30 month well child visits. The goal of the activity is to provide pediatricians with data-driven performance measures and ensure follow up and referral to appropriate resources for children at risk for hearing loss. In Connecticut, a QI coach initiates communication with the the primary care provider for each baby who is diagnosed with hearing loss. The QI coach, a board-certified pediatrician and AAP EHDI Chapter Champion, helps providers ensure that babies receive appropriate follow up after diagnosis, including linkage to EI, otolanryngology, opthalmology, genetics and family support services. She provides participating pediatricians with monthly dashboards on their progress connecting babies to services. Pediatricians are also required to review quarterly statewide data on follow of newborns with hearing loss and provide input into improvement strategies. This session will review these QI efforts.
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Lisa Honigfeld - POC,Primary Presenter,Author
Child Health and Development Institute
     Credentials: Ph.D. Medical Sociologist
     Other Affiliations: Vice President for Health Initiatives, Child Health and Development Institute
      Lisa Honigfeld directs CHDI’s efforts to strengthen pediatric primary and preventive care. Her responsibilities include work designed to test innovations in child health services delivery, policy and systems. Lisa has more than 25 years of experience working in child health organizations, such as the American Academy of Pediatrics, Saint Francis Hospital in Hartford and ProHealth Physician. She serves on several statewide committees related to medical home, care for children with special health care needs, family support, pediatric training and quality improvement. Her work focuses on: care coordination, developmental screening, the interface between primary care and community and services, and expanding the capacity of pediatric primary care to address mental health issues. Lisa has a BA in sociology from the University of Massachusetts and an MA and PhD, both in sociology, from the University of Chicago. She holds a faculty appointment in Pediatrics at the University of Connecticut School of Medicine.

Financial - Receives Grants for Other activities from Connecticut Department of Public Health.  

Nonfinancial - No relevant nonfinancial relationship exist.
Vicki Hunting - Co-Presenter,Author
Hands & Voices
     Credentials: BA, Parent of young adult with hearing loss
     Other Affiliations: Quality Improvement Advisor
      Vicki Hunting lives in Des Moines, Iowa with her husband Mark and two daughters; the youngest is a young adult with a profound hearing loss. She has worked in project management, process re-engineering and quality/process improvement for over 18 years. In her more recent experience she is a Quality and Operational Improvement Engineer at the University of Iowa, Center for Child Health Improvement and Innovation and trains mental health providers on the use of quality improvement approaches to improve the system of care for Iowa's children and youth with severe emotional disorders. She has experience in using the Model for Improvement as a framework for quality improvement projects, testing, implementing and spreading changes. Using data for improvement, developing and interpreting run charts and control charts, utilization of Plan-Do-Study-Act (PDSA) cycle to test changes are also part of her experiences. Vicki has been involved in Iowa H&V for over 10 years.

Financial - No relevant financial relationship exist.

Nonfinancial - No relevant nonfinancial relationship exist.
Brenda Balch - Co-Presenter,Author
Private Practice Pediatrician
     Credentials: Board certified pediatrician, CT AAP Chapter Champion for EHDI, Member EHDI Advisory Board
     Other Affiliations: Connecticut Children's Medical Center clinical staff
      Dr. Balch serves as the CT AAP EHDI Chapter Champion. In this role she works with the state EHDI program and child health providers across Connecticut to support the goals of early detection and intervention. Dr. Balch also is very active in efforts to provide relief to children in Haiti as well as other medical missions.

Financial -

Nonfinancial -