Researchers present clinicians' perspectives on the implementation process for appropriate referrals for hearing loss (HL) screening. The authors implemented a prompt in the electronic health record to remind clinicians to consider audiology referral for patients 55 and older and then observed clinic processes and conducted semi-structured interviews with family medicine clinicians who interacted with the technology. Data was analyzed using thematic, framework and mixed methods integration strategies. The team interviewed 27 clinicians and conducted 10 field observations. Thematic analyses resulted in six themes including: 1) the prompt was "overwhelmingly" easy to use and was accurate; 2) clinician considered the prompt an effective way to increase awareness of patients about HL; 3) clinician and staff buy-in was vital in implementing the prompt; 4) clinicians prioritized the prompt during annual visits; 5) medical assistant involvement in workflow varied by health system, clinic and clinician; and 6) the prompt resulted in more conversations with patients about HL. Given that integration of the screening prompt varied, further research is needed to understand how to leverage clinician and staff buy-in and whether implementation of a new clinical prompt has a sustained impact on HL screening and patient outcomes.
Implementation of a Hearing Loss Screening Intervention in Primary Care
Melissa DeJonckheere, PhD, et al
University of Michigan, Department of Family Medicine, Ann Arbor, Michigan
https://www.annfammed.org/content/19/5/388
