Implementation of a Hearing Loss Screening Intervention in Primary Care.

Authors

Melissa DeJonckheere
Michael M McKee
Timothy C Guetterman
Lauren S Schleicher
Elie Mulhem, Beaumont Health
Kate Panzer
Kathleen Bradley, Beaumont Health
Melissa A Plegue
Mary E Rapai
Lee A Green
Philip Zazove

Document Type

Article

Publication Date

9-2021

Publication Title

Annals of Family Medicine

Abstract

PURPOSE: Hearing loss (HL) is underdiagnosed and often unaddressed. A recent study of screening for HL using an electronic prompt showed efficacy in increasing appropriate referrals for subsequent testing. We build on the results of this study using a qualitative lens to explore implementation processes through the perspectives of family medicine clinicians.

METHODS: We collected clinic observations and semistructured interviews of family medicine clinicians and residents who interacted with the HL prompt. All data were analyzed using thematic, framework, and mixed methods integration strategies.

RESULTS: We interviewed 27 clinicians and conducted 10 observations. Thematic analysis resulted in 6 themes: (1) the prompt was overwhelmingly viewed as easy, simple to use, accurate; (2) clinicians considered prompt as an effective way to increase awareness and conversations with patients about HL; (3) clinician and staff buy-in played a vital role in implementation; (4) clinicians prioritized prompt during annual visits; (5) medical assistant involvement in prompt workflow varied by health system, clinic, and clinician; (6) prompt resulted in more conversations about HL, but uncertain impact on patient outcomes. Themes are presented alongside constructs of normalization process theory and intervention outcomes.

CONCLUSION: Integration of a HL screening prompt into clinical practice varied by clinician buy-in and beliefs about the impact on patient outcomes, involvement of medical assistants, and prioritization during clinical visits. Further research is needed to understand how to leverage clinician and staff buy-in and whether implementation of a new clinical prompt has sustained impact on HL screening and patient outcomes.

Volume

19

Issue

5

First Page

388

Last Page

395

Recommended Citation

DeJonckheere M, McKee MM, Guetterman TC, Schleicher LS, Mulhem E, Panzer K, Bradley K, Plegue MA, Rapai ME, Green LA, Zazove P. Implementation of a Hearing Loss Screening Intervention in Primary Care. Ann Fam Med. 2021 Sep-Oct;19(5):388-395. doi: 10.1370/afm.2695. PMID: 34546945; PMCID: PMC8437567.

DOI

10.1370/afm.2695

ISSN

1544-1717

PubMed ID

34546945