Toolkit for Providers Serving Children with Hearing Loss
Tip #8: Use Fax-Back Form to Share Critical Test Results
What We Learned:
• Although PCPs view themselves as responsible at least in part for ensuring adequate follow-up after newborn hearing screening, not all PCPs have the result of the screen available when they see newborns discharged from the birth hospital for their initial well child visits.
• Difficulties accessing the screen result impact the PCP’s ability to serve as a medical home for their patient.
What We Did:
• Suggest birth hospitals treat a “refer” on a screen as a “critical test result” Suggest birth hospitals, in addition to ensuring that follow-up appointments are made, also inform state EHDI program and child’s PCP.
• We reviewed PCP case records to determine whether the results of newborn hearing screens were documented.
• In some cases the PCP is informed via an EHR. In those cases where there is no EHR, or where in-patient and outpatient EHRs don’t communicate, we tested use of a Fax-back form between the birth hospital and the PCP.
• The fax-back form contained the child’s hearing screen result, and was faxed to the child’s PCP of record prior to the newborn’s discharge from the birth hospital.
Questions for My Practice:
• Are we receiving newborn hearing screen results? If so, How?
• Is the screen result documented in the child’s record? Click here for a sample record with screen result.
• Do local birth hospitals have our fax number to send critical test results e.g. “refer” on newborn hearing screen?
• Do we confirm with the birth hospital e.g. by faxing back confirmation that we have received critical test results?
• Do we have an internal process to ensure that incoming fax results are filed or copied to the child’s chart?
• Do we routinely discuss the results of the newborn hearing screen with families at well child visits?
Changes to Try in My Practice:
• Review 10 case records of infants to see how we are doing with documenting newborn hearing screening results.
• Work with local birth hospital to test use of a fax-back form to transmit “refer” results on NHS.
When infants “refer” after newborn hearing screening, families don’t know what to expect next in terms of re-screening or diagnostic testing.
• For infants found to have a permanent hearing loss, families don’t know what further tests are needed, which providers they need to consult with, or interventions available.
• The number of different professional disciplines involved in management of children with hearing loss is confusing for most families, and it’s hard for them to keep track of whether they have received all the consultations they need.
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