Implementation of a Hearing Loss Screening Intervention in Primary Care.
Ann Fam Med
; 19(5): 388-395, 2021.
Article
em En
| MEDLINE
| ID: mdl-34546945
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.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Perda Auditiva
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article