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Related Experiment Video

Updated: May 26, 2026

Behavioral Assessment of Hearing in 2 to 4 Year-old Children: A Two-interval, Observer-based Procedure Using Conditioned Play-based Responses
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Identifying quality improvement opportunities in a universal newborn hearing screening program.

Kenneth C Deem1, Ernesto A Diaz-Ordaz, Brian Shiner

  • 1Department of Otolaryngology–Head and Neck Surgery, University at Buffalo, State University of New York, Buffalo, New York, USA. kcdeem@gmail.com

Pediatrics
|December 14, 2011
PubMed
Summary

This study shows a practical method for hospitals to assess and improve universal newborn hearing screening (UNHS) quality. Reviewing records and providing feedback helps identify and implement necessary changes for better infant hearing health outcomes.

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Area of Science:

  • Healthcare Quality Improvement
  • Pediatric Audiology
  • Public Health Screening

Background:

  • Hospital-based universal newborn hearing screening (UNHS) programs require quality assurance.
  • Many hospitals face resource limitations for implementing quality protocols.

Purpose of the Study:

  • To evaluate a practical approach for measuring UNHS quality indicators.
  • To identify opportunities for improvement in UNHS programs.

Main Methods:

  • Conducted site visits and a 2-year retrospective record review across 4 hospitals.
  • Facilitated feedback sessions with nurses, audiologists, and otolaryngologists.
  • Identified improvement opportunities and proposed system changes.

Main Results:

  • Screening rates exceeded 99% in all hospitals.
  • Significant variations in referral and diagnostic testing rates were observed.
  • Hospitals adjusted screening and referral processes, increasing diagnostic follow-up rates fourfold through Early Intervention referrals.

Conclusions:

  • Reviewing records effectively established quality indicators for UNHS programs.
  • Feedback sessions successfully identified improvement areas and led to system changes.
  • This study offers a practical, data-driven quality improvement model for UNHS programs.