March 13-15, 2016 • San Diego, CA


  |   -   |  6 - Follow-up, Tracking and Data Management

Reduction of Loss to Follow-up Rates through Scheduling Diagnostic Appointments Prior to Discharge

National Loss to Follow-up (LTF) rates in 2013 fluctuated between 0% and 86.7%. Idaho ranked 23 of 52 EHDI programs during that time with a LTF rate of 24%. Loss to Follow-up is defined as infants that referred on their Newborn Hearing Screening (NHS) who either never received a hearing diagnosis or their diagnosis was not reported to the EHDI program. Infants that do not pass their hearing screening at birth are discharged from the birthing facility and their diagnostic testing results may never be received by the state EHDI program. A successful PDSA out of the NICHQ collaborative was adapted by Idaho EHDI’s Advisory Committee focusing on reducing LTF. The approach of this PDSA was to schedule diagnostic appointments for children that referred prior to discharge from the birthing facility. The Pilot hospital was selected because it was a large birthing facility with centralized scheduling and a pediatric outpatient audiology center. The hospital was also outsourcing the operations and management of their NHS program. The Pilot Hospital saw their LTF rates drop from 26.3 to 10.3% for the same time period from the prior year. The first cycle ambitiously incorporated scheduling 2 diagnostic appointments prior to discharge, however the 2nd appointment was dropped in subsequent PDSA cycles due to feedback received from the audiology centers. Later cycles incorporated additional birthing facilities without centralized scheduling managed by the same outsourced company. Significant reductions were realized by the additional birthing facilities and the PDSA is being spread to additional hospitals. This presentation shares how Idaho EHDI worked closely with the outsourced screening program applying NICHQ/ PDSA successes and methodologies to achieve significant reductions in LTF rates.

  • Illustrate the effectiveness of scheduling diagnostic follow-up of infants that refer prior to discharge
  • Illustrate effective collaboration between state EHDI Programs and Outsourced Newborn Hearing Screening Companies
  • Highlight Successful use of NICHQ/ PDSA Methodologies in an effort to reduce LTF

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Brian Shakespeare (Primary Presenter), Idaho Sound Beginnings, ShakespB@dhw.idaho.gov;
Brian Shakespeare is the State EHDI coordinator for Idaho Sound Beginnings. He joined Idaho Sound Beginnings as a data manager in 2012. He moved into the EHDI coordinator position in 2014. He has background in psychology and working with children with pervasive developmental disabilities. He enjoys rock climbing and disc golfing with his wife and 2 Boston Terriers and Boxer. Email shakespb@dhw.idaho.gov for photos of his puppies.


Financial -

Nonfinancial - No relevant nonfinancial relationship exist.

J. Hope Ramos (Co-Presenter), Peloton, Hope.Ramos@natus.com;
Hope obtained her Bachelors of Arts in Speech Language Pathology & Audiology in 2006 and Doctorate in Audiology from the University of North Texas in 2012. She is currently an Audiologist with Peloton Screening Services as the Area Supervisor in the states of Idaho & Iowa. Although she was born and raised predominately in Texas, she is now relocated in Boise, Idaho and never intends to leave the Northwest! She enjoys her hobbies of health & fitness and traveling.


Financial - Receives Other financial benefit for Other activities from Employee of Natus Medical.  

Nonfinancial - No relevant nonfinancial relationship exist.