Evaluation of an Audiology-led Retrocochlear clinic: A 6-year retrospective cohort study

Ms Amber Hall1, Ms Katye Trafford1, Ms Caitlin Brandenburg2,4, Ms Elizabeth  Ward2,4, Ms Michelle  Pokorny4, Ms Marnie Seabrook1, Associate Professor Bernard Whitfield3,5

1Speech Pathology and Audiology Department, Logan Hospital, Meadowbrook, Australia, 2Centre for Functioning and Health Research , Brisbane, Australia, 3Integrated Specialist ENT Service,Department of Otolaryngology Head and Neck Surgery, Logan Hospital, Meadowbrook, Australia, 4Allied Health Research, Gold Coast Health, Southport, Australia, 5School of Medicine, Griffith University, Southport, Australia, 6School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia

Introduction:

Allied health professional (AHP) first-point-of-contact clinic models have been shown to be an effective and safe strategy to increase public health capacity and reduce overall wait times. In these clinics, AHPs assess, manage and discharge appropriate, low-risk patients on medical/surgical outpatient waitlists with minimal input from specialists.

Patients with suspected retrocochlear pathology are usually referred to ENT specialist clinics and only 1-2% receive a positive diagnosis. Audiology-led screening has been implemented in some clinics to reduce demand on ENTs, supported by a small amount of research evidence. This study aimed to expand on this by evaluating the clinical and health service outcomes for an audiology-led adult Retrocochlear Clinic using a large clinical cohort across a 6 year period.

Design:

This retrospective cohort study included all patients referred to an audiology-led Retrocochlear Clinic in Queensland from 2013 to 2019 (n=1123).

Results:

Almost three-quarters (73.7%) of patients referred to the Retrocochlear Clinic were discharged without the need for separate ENT consultation. Of those discharged, only 1.8% were re-referred to the ENT clinic within 12 months of discharge, with only one patient for the same reason as the original referral. No adverse events were reported. Waiting times significantly (p<0.001) decreased from a median of 748 days to 63.5 days over the 6 years. There was a significant (p<0.001) improvement in attendance rates from 52.2% to 90% over that time. The proportion of patients seen within clinically recommended timeframes increased from under 15% at the clinic’s inception, to over 90% within 3 years for routine patients and within 4 years for semi-urgent patients..

Conclusion:

An audiology-led Retrocochlear Clinic is a safe and effective alternative service model which was able to independently manage the majority of its referrals and contribute to reduced waiting times.


Biography:

Katye Trafford is Audiology Stream Leader of the Logan Hospital Audiology-led First Point Of Contact ENT clinics.  She works concurrently at the Queensland Children’s Hospital as clinical representative for their ENT model of care.  Katye is presenting this work on behalf of the lead authors Amber Hall (Clinical Audiologist, Logan Hospital) and Caitlin Brandenburg (Principal Allied Health Project Officer, Metro South Health).

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