Improving transition outcomes in adolescents with permanent hearing loss

BMJ Open Qual. 2019 Jun 21;8(2):e000336. doi: 10.1136/bmjoq-2018-000336. eCollection 2019.


Young people with permanent hearing loss need to transition into adult services and engagement with the transition process is required to achieve this. Although there are clear national recommendations about the transition process and transfer to the adult services limited evidence has been published about the implementation and efficacy of transition programmes in young adults with permanent hearing loss. The primary aim of this quality improvement project was to significantly increase the number of teenagers with a clear transition protocol documented in their notes. The secondary aims were to ensure good medical and audiological outcomes based on all completing their medical investigations prior to transfer to the adult services and also based on a survey regarding attitudes to hearing aids use. A multiphase intervention programme was developed; (1) staff update with national transition protocols, (2) development of a clear transition protocol, (3) allocated key worker (4) access and (5) engagement. Through these interventions we increased the number of teenagers who had a clear transition protocol documented in their notes from 11% to 91%. 84% of our teenagers had completed their medical investigations, although documented discussion about the investigations had been done with 100% of the cohort. 9.2 % of adolescents felt pressurised to use hearing aids compared to 35% prior to the interventions. This project resulted in clear, measurable conclusions and we have shown that we better understand the needs of our patients and the improvement is sustainable.

Keywords: PDSA; checklists; quality improvement; transitions in care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Audiology / statistics & numerical data
  • Female
  • Humans
  • Male
  • Outcome Assessment, Health Care / statistics & numerical data*
  • Persons With Hearing Impairments / psychology
  • Persons With Hearing Impairments / rehabilitation*
  • Persons With Hearing Impairments / statistics & numerical data
  • Quality Improvement
  • Surveys and Questionnaires
  • Transitional Care / standards*
  • Transitional Care / statistics & numerical data
  • Young Adult