Newborn Hearing Screening
UNHS Programs: Data Management and Quality Assurance
Data Management and Quality Assurance
Managing your program's data is crucial to ensuring the success and quality of your newborn hearing screening program. A good data management system will ensure that no babies are lost to follow-up, as well as help ensure the quality of your program.
Statewide tracking and surveillance
The Washington State Department of Health (DOH), in cooperation with the Centers for Disease Control and Prevention (CDC), developed a statewide EHDDI Tracking and Surveillance system linked to the metabolic screening system. The tracking and surveillance system helps to ensure that all babies are screened for hearing loss prior to one month of age, those that are referred receive diagnostic audiological evaluation by 3 months of age, and those that are diagnosed with hearing loss receive early intervention by 6 months of age.
While Washington state does not mandate universal newborn hearing screening, about 96% of infants are screened before hospital discharge. All birthing hospitals (except two military facilities) and many clinics in Washington report newborn hearing screening results and diagnostic results to EHDDI.
The EHDDI program collaborates with the Early Support for Infants and Toddlers (ESIT) program to determine if infants with hearing loss receive appropriate and timely early intervention services. The ESIT program is Washington state’s Part C program that provides services to children birth to 3 years of age who have disabilities, including hearing loss. For updates on this project, please see the EHDDI program website and the ESIT website.
For more information about this project, please contact:
Washington State Department of Health
1610 NE 150th St.
Shoreline, WA 98155
Phone: 206-418-5613 or 888-WAEHDDI (toll-free)
Data management for your hospital
It is important to have a system in place within your hospital to internally manage the data collected from your newborn hearing screening program. This will help you manage your workload and make sure that no babies are missed.
Many larger programs prefer to purchase one of the commercially available software programs, while smaller programs often find simpler, less expensive options sufficient.
We recommend that all hospitals, regardless of size, keep a log sheet or book to manage daily screening needs. This helps ensure that all babies get screened prior to discharge.
Sample spreadsheet for data management (XLS)
Before choosing a data management option, you should consider what data you want to monitor and how much you want the system to do for you.
Commercially available software
If your hospital has a large number of births, we recommend that you purchase one of the commercially available software programs. In addition to tracking data, these software programs can generate regular reports and follow-up letters to families and physicians.
There are several software products that are currently commercially available for newborn hearing screening data management:
Some of these companies can be used for managing all aspects of a statewide newborn screening program, such as hearing screenings, birth defect information, and metabolic tests.
Hospitals with smaller numbers of births may find that the software included with the equipment they purchase to be sufficient. Some of the hospitals even find a simple logbook or excel spreadsheet to be adequate.
What data should you monitor
The number of births your hospital has will generally dictate how you decide to track and monitor your data. You should be able to easily obtain the following information:
- Overall refer rate. How many babies were screened, how many babies passed, and how many referred.
- Refer rates for individual screeners. This tells you how well each screener is doing.
- Infants that were missed prior to discharge. You will need to follow-up and make sure these infants obtain a hearing screening.
- Infants that need to return for a re-screen. You will need to make sure these infants return for their follow-up re-screen appointments.
- Infants that need a diagnostic audiologic evaluation. You will need to follow-up with the infant's parents or pediatrician to ensure that they scheduled a diagnostic evaluation.
The Department of Health sends hospitals monthly reports with these screening statistics. Some hospitals find these reports to be sufficient for data management purposes. As mentioned above, each hospital, regardless of size, should keep its own record of hearing screenings, be it a log sheet, book, or electronic record, to manage daily screening needs.
Quality assurance guidelines
The following guidelines serve as a good baseline by which to monitor your program:
- Within three months of initiating a hearing screening program:
- Maintain a referral rate no higher than 8% for the initial screening.
- If the hospital performs outpatient rescreening, maintain a referral rate no higher than 4%.
- Within six months of program initiation, screen a minimum of 95% of infants prior to discharge or before 1 month of age.
- The benchmark for percent of infants lost after not passing the initial screen should be 10% or less.
- Institute a tracking system to monitor referral rates and to assist in the follow-up of infants referred for a rescreen or diagnostic evaluation.