Reduce false-positive results and loss to follow-up through systematic modifications in Universal Newborn Hearing Screening at a large public hospital.

During a pilot program, neonates who failed technician-performed automated auditory brain stem response were scheduled for diagnostic evaluation. In year 1, audiologists rescreened neonates who failed, and those who did not pass were screened as outpatients. For years 2 through 4, neonates who failed were rescreened by technicians before inpatient audiology rescreening.

For the pilot, 3759 neonates were screened; 1% (n=43) failed and 44% (n=19) were lost to follow-up. In year 1, 15,297 neonates were screened and 2% (n=365) failed; audiology rescreening reduced this to <1% (n=129). Outpatient rescreening yielded 0.5% (n=70) who failed; 17% (n=12) were lost to follow-up. In year 2, 16,384 neonates were screened, 3% (n=456) failed, and 1% (n=167) failed after technician rescreen; audiology rescreening reduced inpatient fails to 0.6% (n=108), and 0.4% (n=61) failed outpatient rescreening; 11% (n=7) were lost to follow-up. Results for years 3 and 4 were similar to year 2, with further reduction in loss to follow-up to 11% (n=6) and 1.7% (n=1).

Successful Universal Newborn Hearing Screening with reduced false-positive results and loss to follow-up can be accomplished with a planned schedule of inpatient rescreens and outpatient rescreening at the birthing facility.