The Office of Head Start has encouraged every program to create a "Culture that Embraces Data."  

We would like to suggest some specific ways that you can apply these ideas to your hearing screening process.  

Like other health and developmental screenings, Otoacoustic Emissions (OAE) hearing screening is a process by which you identify children who need follow-up evaluation and intervention. Your "plan to succeed" should therefore focus not only on conducting the screening procedure, but on what happens after that!  

As you "get people on board," with utilizing OAE screening and follow-up data, include staff who will conduct the screening, those who have clerical responsibilities for tracking and data management, your Health Services Advisory Committee (HSAC), local health care providers, and a pediatric audiologist who can assist with training and also with diagnostic assessment as needed.

As you collect and "dig into data" include screener training, as well as child screening outcomes. For example, you can:

~ Assess the number of children you expect to serve, and the number of staff who need to be trained
(or retrained) to conduct the screenings.

~Document your training activities along with screener proficiency.  Keep a record of screeners who have watched all recommended video tutorial modules and have completed the companion knowledge check.  Also, ask your partner pediatric audiologist, or a highly experienced screener, to complete a skills checklist on each screener.  Place this information in each screener's file to verify that you have a standardized process in place for training  staff responsible for hearing screening and follow-up.

~ Include a copy of screening results, and any needed follow-up outcomes, in each child's health record.

~Enter each child's screening and follow-up outcomes into a tracking system that gives you the capacity to aggregate data and monitor program quality. Check whether your OAE pass and refer rates compare with data collected from other programs. For example, when screeners are adequately trained, it is typical for about 75% of children to pass the initial OAE screening and about 25% to need a second OAE screening. If you have the capacity to look at each screener's pass rate, this can also be helpful in knowing whether further targeted training is needed.  

~Note the percentage of children referred from OAE hearing screening for health care consultation (usually about 8% of the total number initially screened) and ensure that they receive the needed OAE rescreen.   

~Note the percentage of children being referred to a pediatric audiologist for evaluation (usually about 1%) and be certain that you know the evaluation outcome. Document the number of children who are diagnosed with a permanent hearing loss (typically about 1 out of every 300).

These data demonstrate ongoing program monitoring that will inform technical assistance activities.  As you collect information, remember to "share and share alike," by communicating individual screening results to parents and health care providers. Discuss screening program outcomes with screeners, your HSAC, and utilize it during your annual Self Assessment and Monitoring processes. Finally, in addition to identifying areas where further training or technical assistance may be needed, remember to "celebrate good times" by recognizing successes and individual contributions to the overall effort. Be generous with expressing thanks to all who contribute directly and indirectly to hearing screening program activities. 

OAE screening is a perfect opportunity to use data to achieve concrete, objective outcomes and to see and share your accomplishments.