Welcome to How to Increase Patient Satisfaction Presenter: Mary - PowerPoint PPT Presentation

Welcome to How to Increase Patient Satisfaction Presenter: Mary Leisses, MS Director of Network Education and Training Starkey Hearing Technologies Starkey.com IHS Organizers Carrie Pedersen Ted Annis Senior Marketing Specialist Member Services Supervisor

Housekeeping  This presentation is being recorded  CE credit is available! Visit ihsinfo.org for details  Note taking handouts are available at ihsinfo.org on the webinar page. Feel free to download now!

Agenda  Satisfaction is a process, not an outcome  Pre-fitting Tools  Fitting Tools  Post-fitting Tools  Q&A (enter your questions in the Question Box any time)

SATISFACTION IS A PROCESS, NOT AN OUTCOME

Why isn’t “They are happy” good enough?  Research has shown that a comprehensive protocol has a major impact on:  Hearing aid brand loyalty;  Utility of hearing aids;  Positive-word-of mouth advertising;  Satisfaction with benefit achieved;  Hearing handicap reduction; and  Hearing aid usage and reduction of hearing aids in the drawer

Why isn’t “They are happy” good enough? Kochkin, et al, Hearing Review 2010

Why isn’t “They are happy” good enough? Kochkin, et al, Hearing Review 2010

PRE FITTING

Pre Fitting Hearing Loss Simulator COSI Demo Care Plan

Hearing Loss Simulator • Explanation of Test Results – Hearing Loss Simulator – Impactful visual depiction of patient’s hearing loss

Client Orientated Scale of Improvement  COSI  An open scale designed for the patient to select which environments are most important for them  This is a great tool because it truly validates what is most important to the patient  A version of this can be found on the Hearing Healthcare Report form  It is also found in the NOAH software

Client Orientated Scale of Improvement • A paper version can be printed out • It is designed to be interactive between clinician and patient • Much of the information would be obtained via the discovery process

Client Orientated Scale of Improvement

Client Orientated Scale of Improvement  As a validation tool, it helps to keep patient and clinician focused on areas that are most important  Going forward, it allows continued validation and to potential demonstrate improvement in quality of life as new situations gain importance

Demonstration • “As midlife approaches, people increasingly draw on right-brain functions. They begin relying less on left brain sequential reasoning and more on emotions, aka “gut feeling” or intuition.” • To arouse the strongest attention, messages Jim Gilmartin, Coming of Age, Inc. should be rich in sensory stimuli

Demonstration • 1 Need = 1 Solution = 1 Demo – Demonstrate benefit for the patient’s ONE most important need • Audibility • Distance • Hearing in Noise • Wireless Accessories – TV – Cell phone – Remote microphone

Demonstration • Transition into recommendation with confirmation of Demo… Audiologist “Isn’t it great to be able to hear the TV like this Mr. …?” “Mrs. …, what would it mean to you if your husband could hear the television like this?”

Care Plan

FITTING

Fitting  Speech Mapping  Speech In Noise Testing  Homework  IFF-it  Reading Out Loud  Auditory Training/Brain Games

Why Speech Mapping?  I know what you are thinking….  One more thing you want us to do….  I don’t have any extra time for this stuff  Equipment is soooo very expensive!

Why Speech Mapping  Allows patient and 3 rd party to “see” what is being “heard”  Allows the clinician to see what the patient may not be able to describe  New wireless technology allows more flexibility and comfort and speed in completing the protocol Moore, 2008

Why Speech Mapping Decrease follow visits by 50% More successful/satisfied patient • 76% of patients with above W/O SM W/ SM average success were fit in 1 Patients 13 12 or 2 visits 50% Reduction Follow Up Visits 70 35 • 47% of patients with below- FU per Pt 5.39 2.92 average success required 4 45% Reduction to 6 visits • 64% of practices do NOT do this Cunningham, 2002 Kochkin, 2011

Speech Mapping Verification • Goal: quick verification of HA response to average inputs • Displays Moderate Fitting target by default (for 65 dB SPL or operator’s preferred level) • Optionally, you can display soft and/or loud targets • This example also shows patient’s thresholds in dB SPL.

Speech Mapping Verification • The thin green line is the target • The thicker green band is the mapped speech signal • Goal is to have green band centered on green line • What do you see here?

Speech Mapping Counseling • Set-up – Input+Gain – Soft and Loud curves

Speech Mapping Counseling • Explanation – Soft vs Loud is ideal audible range for hearing – 90% of signal should fall within this range

Patient speak • What are we looking at? – The blue and purple mark the range for soft to loud speech – If sound falls below the blue line, you would struggle to hear it – The gold bars is what you hear without the hearing aids – Our goal is to get at least 90% of all speech between the blue and purple – The blue/red bars show what you can hear now with the hearing aids

Realistic Expectations Why not say “All”? Why not say “All”?

Why measure SNR Loss?  It’s the #1 complaint of hearing -impaired patients  It can’t be reliably predicted from the pure tone audiogram or other standard audiometric tests

An Example • PTA = 52/53  PTA = 53/55 • WRS = 76%/80%  WRS = 80%/84% SNR Loss = 3 dB, SNR Loss = 9 dB, 9 1 dB dB

QuickSIN

QuickSIN  Equipment you need  QuickSIN CD  Headphones/ear inserts  Set up  CD in the audiometer  Patient in Sound Booth

QuickSIN  One-minute method for estimating number of hair cells that are missing 1. The dusty bench stood by the stone wall +25 dB ___ 2. We dressed to suit the weather of most days +20 dB ___ ___ 3. The water in this well is a source of good health +15 dB 4. That guy is a writer of a few banned books ___ +10 dB 5. The door was barred, locked and bolted ___ + 5 dB 6. A big wet stain covered the floor ___ + 0 dB 25.5 - ______ SNR deficit

SNR Loss Assists with Technology Selection SNR Loss Category Technology 0-2 dB Normal Omnidirectional 2-7 dB Mild Fixed or Dynamic Directional 7-15 dB Moderate Dynamic or Adaptive Directional >15 dB Severe FM or Remote Microphones

So you are going to fit a hearing aid  We need to realize  Our patients think it will work perfectly everywhere  Family thinks a hearing aid gives super human hearing  They are only going to hear what they want to hear…  What is our reality?  None of the above happens…

What does a hearing aid do?  Amplifies soft sounds in environment  Reduces loud sounds in environment  Shouldn’t that be enough?  Does a hearing aid know what to amplify and what to reduce?  NO!

So how do we handle this?  Words you will never use  “Always”  ”Removes”  Words you can use  “Comfort”  “Focus”

Examples • Never say • Ok to say – “Removes all – “Provides comfort in background noise” busier environments” – “Will only amplify your – “Will help you focus on wife’s voice” speech” How are these statements different?

Learning to hear again  We need to counsel on  They are going to hear things they haven’t heard for awhile  IFF’it process  Identify the “new” sound  Find the “new” sound  Decide if they need to pay attention or can forget it  Have them keep a “sound” journal  Write down “new” sounds they discovered  Promote positive stories

Learning to hear again  Stay away from negative statements  “Things are going to be really loud.”  “Restaurants are really noisy.”  “Write down what you don’t like and we will make changes.”  Focus on the positive  “How much fun was it playing games w/the grandkids?”  “What sounds of life have you been missing?”  “How great is it not to fight over the TV?”

Learning to hear again  If you have a “Nervous Nellie”  Give them a wearing schedule  Give them permission to take aid out for a couple of hours  Limit first few days to wearing at home only  Limit places they can wear it in the “outside” world

Learning to hear again  Why do they need to wear it at home?  Our homes make a lot of sounds.  It teaches them to ignore non-important sounds.

Learning to hear again  Focus on what they want to improve in their life  This isn’t the time to take up bowling…  Word your verbiage specific to their world…aka…Discovery…

The family…  We are not giving super human hearing…  Unaided/aided testing will reinforce this  Maximum range of gain “strength” is 6 ft.  If she is doing dishes in kitchen, he is not going to hear her perfectly in living room while watching TV  They need to say patient’s name first to get their attention