New York State Universal Newborn Hearing Screening Demonstration Project: Inpatient Outcome Measures

TLDR

The study assessed the feasibility of universal newborn hearing screening by analyzing inpatient outcome measures across eight geographically diverse New York State hospitals over three years. Screening employed transient evoked otoacoustic emissions alone or combined with auditory brain‑stem response, with outcomes such as misses, refusals, and fails recorded and evaluated by year, nursery type, and location, leading to implementation in six hospitals in year one and the remaining two in year two. Across 69,761 newborns (96.9 % of live births), the program achieved a 4.04 % fail rate, 2.61 % miss rate, and 6.63 % referral rate, with outcome measures improving over time and higher fail/miss rates in NICUs and New York City hospitals, demonstrating acceptable inpatient outcomes and supporting universal screening feasibility.

Abstract

To evaluate the feasibility of universal newborn hearing screening by examining inpatient outcome measures from 8 hospitals located in geographically diverse areas of New York State over a 3-yr period.Funding was provided by the New York State Department of Health to implement predischarge hearing screening programs in the neonatal intensive care units (NICUs) and well-baby nurseries (WBNs) of eight hospitals. Various screening protocols including transient evoked otoacoustic emissions alone or in combination with conventional auditory brain stem response or screening auditory brain stem response were implemented by each site. Measured outcomes included rate of misses, refusals, and fails. Results were analyzed as a function of year of operation, nursery type, and geographic location.Six out of eight hospitals successfully implemented universal hearing screening during the first year, and the remaining 2 hospitals implemented programs during the second year of the project. Over a period of 3 yr, 69,761 newborns were screened at the eight hospitals representing 96.9% of all live births. The overall fail rate (4.04%) combined with the miss rate (2.61%) resulted in 6.63% of infants referred for outpatient follow-up. Mean data indicated that inpatient outcome measures improved with year of operation, with most individual hospitals also showing improvements. Both fail and miss rates were higher in the NICU than in the WBN and for hospitals located in New York City than in other regions of the state.Inpatient outcome measures of a universal newborn hearing screening project, which involved multiple centers across geographically diverse regions of New York State, were acceptable in terms of successfully screening a high percentage of live births and attaining low refer rates for outpatient screening. This study adds to the growing body of literature supporting the feasibility of screening all newborns before hospital discharge.