Hearing Implant Program

Hearing Implant Program

Much of the focus on improving access to cochlear implantation (CI) starts with recognition of candidacy, but the process from initial evaluation to surgery also has several points of inefficiency that hinder patient access to care. Following a focused team initiative to increase internal referrals for CI evaluation, novel methods of efficiently identifying candidates were needed to manage increases in volume with the same resource availability (eg, time and personnel). Shared medical appointments (SMA), wherein multiple patients are seen by 1 or more providers in 1 coordinated visit, have been successfully implemented in many other settings but have not been utilized for determining cochlear implant candidacy.

The Hearing Benefit Screening/Cochlear Implant SMA was introduced in September 2017, and 76 potential candidates have participated in 2019. Potential adult CI candidates with a recent audiogram (completed within 6 months) are preferentially scheduled for an SMA as the first step of their CI evaluation. The SMA accommodates up to 6 candidates (and at least 1 family member) in one 120-minute session. Patients have access to both a surgeon and audiologist during the session, as well as the unique opportunity to interface with other potential candidates. Each session consists of medical intake and evaluation, aided speech recognition screening, education, and expectation setting. Subjective questionnaires are also completed and inform the screening process. Patients leave the appointment with any necessary orders for medical follow-up as needed. The newly introduced SMA format has increased efficiency of patient scheduling and progress through the CI candidacy process. In particular, surgeon access has been improved and patients are ready for team evaluation and approval in a more coordinated fashion, both expediting and simplifying the candidacy process. Provider time is optimized by accommodating more patients in a shorter but more effective time frame. Patient feedback has also been positive.

Patient Satisfaction Responses (N = 76)

2019

Survey QuestionAverage Response Rating
I gained valuable information from other patients' questions4.14/5
There was adequate time for my questions4.61/5
I gained valuable information from the facilitator4.75/5
My medical needs for this appointment were met4.41/5
I would recommend a shared medical appointment to other patients4.43/5
Patient Comments
Comments
“I like that she explained everything clearly. I like group settings because you learn from other people.”
“Thank you so much for my chance at hearing better. Great job teaching and showing honest care. I felt very at ease.”
“Took lots of time to explain - good for covering a lot of information and gathering medical history in a short amount of time.”
“Totally different than one on one. I found it comfortable for this particular issue. It was handled well.”
“This combined session was very helpful and encouraging to me. I think shared appointments help participants learn about others having the same issues.”
“Thank you! Much better than a 1:1 appointment setting. Great team."