Implementation of a Hearing Loss Screening Intervention in Primary Care

Area of Science:

• Primary Care
• Audiology
• Health Services Research

Background:

• Hearing loss (HL) is frequently underdiagnosed and untreated.
• Electronic prompts have shown promise in increasing referrals for hearing loss testing.
• Qualitative research is needed to understand implementation barriers and facilitators.

Purpose of the Study:

• To explore the implementation of an electronic hearing loss screening prompt in family medicine settings.
• To understand the perspectives of family medicine clinicians on using the HL screening prompt.
• To identify factors influencing the successful integration of HL screening into primary care.

Main Methods:

• Qualitative study involving clinic observations and semistructured interviews with 27 family medicine clinicians and residents.
• Thematic analysis and framework analysis were used to analyze the collected data.
• Data integration strategies were employed to synthesize findings from observations and interviews.

Main Results:

• The HL screening prompt was perceived as easy to use and accurate by clinicians.
• Clinicians viewed the prompt as effective for raising patient awareness and initiating conversations about hearing loss.
• Key factors for successful implementation included clinician and staff buy-in, prioritization during annual visits, and varied medical assistant involvement.

Conclusions:

• Integration of HL screening prompts is influenced by clinician beliefs, staff engagement, and workflow prioritization.
• Further research is necessary to optimize the use of clinician and staff buy-in for sustained impact.
• The long-term effects of HL screening prompts on patient outcomes require additional investigation.