NAL

Hearing Screening Program

    Patty Shappell, Au.D.CCC-A
Hearing Screening Program Director
Email: pshappell (at) nalweb (dot) com
Program Coverage
infant having hearing screen
Early detection of hearing impairment significantly increases an infant's chance of early treatment and normal development.  NAL has successfully established screening programs that provide the best avenue of identification and follow-up of hearing loss.  The NAL hearing screening program is cost effective to hospitals and frees up precious nursing time.  We provide all aspects of the program: staff, screening equipment and supplies, follow-up, and tracking.

Each newborn will be screened prior to discharge.  Screening will be provided for all well-baby and NICU babies.  Screening will be done at an optimal time in order to provide the most accurate test results.  Screening results will be documented in the medical record and on the baby's immunization record.  Parents will be sent home with the results of the screen and an educational brochure regarding the screening program and the importance of monitoring speech, language, and hearing developmental milestones. 

While we believe that this is a service that should be utilized by all patients, we understand the parent's right to refuse the screening.  If the parents are concerned about the cost of screening, we work in conjunction with the EAR Foundation of Arizona to offer a voucher program that removes financial barriers to screening.  In addition, we provide contact information for pediatric audiology providers if the parent requests the screening during the outpatient appointment.  All patients opting not to have their infant screened will be asked to sign a waiver.  If the waiver is requested, the baby's pediatrician will be notified that the screen was not completed in the hospital.
 
Follow-up:
 
Follow-up is the most challenging element of a newborn hearing screening program.  The NAL program excels in getting babies from an inpatient refer to outpatient follow-up by one month of age as recommended by the Joint Committee on Infant Hearing, Pediatrics, 2007 Position Statement.  Infants who refer (do not pass) the initial inpatient hearing screening will be scheduled for a follow-up screening within 2 to 4 weeks of birth as recommended by the state newborn hearing screening guideline.  NAL contacts the families of infants that refer by phone and/or letter.  NAL has established protocols to ensure that all infants have an opportunity for repeat screening either by NAL or by another provider based on insurance requirements.  Timely follow-up is done not only to ensure the earliest detection, but to also alleviate parental concerns.  Babies not passing the outpatient screening will be referred to their primary care physician, or an audiology program as directed by the primary care physician/insurance for diagnostic hearing evaluation and /or medical follow-up.  Any concerns about risk factors for delayed onset or progressive hearing loss are discussed with parents and follow-up recommendations are provided.  Parents will be counseled regarding the need for diagnostic follow-up and will be provided with guidance in obtaining diagnostic services.
 
Quality Assurance: 
 
NAL has processes in place to ensure the highest quality screening program.  Data will be collected on a daily basis and reviewed regularly to enable us to evaluate the program.  We will be examining data for: 
 
  Assurance that all babies are being screened.  We will be comparing our numbers with the numbers of hospital births.

Follow-up on all false-positives and true-positives to ensure that these babies are re-tested for appropriate follow-up.

Accuracy and efficiency of our screeners.

           
      
The Arizona Department of Health Services generates a quarterly scorecard for all hospital hearing screening programs.  The purpose of the scorecard is to monitor the quality indicators of program performance on a state level.  The scorecard reports the following data:

                  Total number of babies screened inpatient
                  The refer rate
                  Timely submission of reports
                  Match to vital records
                  Follow-up at outpatient

NAL is proud to report that our programs exceed the state average in all elements monitored.

Our Team: 
 
NAL will provide a dedicated team including Audiologists, Program Coordinators and Hearing Screeners to provide the program along with consultation and medical support provided by the NAL neonatologists.
 
Reporting:           
           
NAL will disseminate reports to:          
           
  The Hospital - We will provide reports to the Pediatric and OB Committee on a regular basis to allow the Medical Staff and administration to actively examine the program and provide input to the process.  Reports will be generated for the hospital to comply with outside regulatory bodies such as JCAHO and Arizona Perinatal Trust.

The State - Using the HI*TRACK software, we will provide the State with reports for data compilation to meet the State newborn hearing screening mandated guideline.
 
Our Experience
 
Neonatology Associates, Ltd. has been providing newborn screening services to area hospitals since 2004.  We have developed a program that provides the best screening and follow-up for newborns with potential hearing impairment.  Our dedication to the mothers, babies and physicians in your community is well established and recognized by all including hospital administration, obstetricians, pediatricians, family practitioners and nursing.  The NAL Hearing Screening Program is one more program of excellence offered by Neonatology Associates, Ltd.
 
Hospitals that NAL is providing Hearing Screening Services
 

Arrowhead Hospital
Banner Baywood Medical Center

Banner Desert Medical Center

Banner Thunderbird Medical Center

Carondelet St. Joseph's Hospital-Tucson
Chandler Regional Hospital

Maryvale Hospital and Medical Center
Mercy Gilbert Medical Center

 

Mountain Vista Medical Center
Northwest Medical Center-Tucson

Paradise Valley Hospital

Phoenix Baptist Hospital

St. Joseph Hospital and Medical Center
Summit Healthcare Regional Medical Center - Show Low
West Valley Hospital