Michelle Pokorny

Clinical Audiologist, Clinician Researcher and Honorary Lecturer, The University of Auckland, NZ

Michelle is a clinical audiologist, clinician researcher, and honorary lecturer at the University of Auckland with a strong interest in public health and service re-design. She completed her PhD through the University of Queensland in 2023 investigating audiology-led models of care in ORL services. She currently works as an Advanced Audiology Practitioner at Te Whatu Ora Counties Manukau and holds an HRC Clinical Practitioner Research Fellowship (2024). Her current research interests include addressing inequities in hearing and ear care in Aotearoa, including the development of innovative services, technologies and tools to provide effective, efficient and sustainable improvements in clinical care.

Inequity in Outcomes after Grommet Insertion as a Driver for Innovation in Ear and Hearing Service Delivery

This paper presents the long-term hearing and functional health outcomes for children undergoing routine grommet insertion, and the whānau perspectives for the provision of post-grommet follow-up. 89 children from South Auckland were recalled for audiology assessment and functional health questionnaire (OMQ20) two years after grommet insertion having undergone standard care follow up. Semi-structured interviews were conducted with 28 whānau/families to explore perspectives of grommet services. Findings demonstrated that most children had hearing loss, but Māori children were significantly more likely to have bilateral hearing loss compared to non-Māori children. All parents reported recent functional health concerns, however, parents of Māori children reported significantly more developmental concerns (hearing, speech development, and attention). Whānau reported strong preferences for follow-up care to include hearing evaluation and to be provided by healthcare providers with perceived expertise in the field (ORL and audiologists). These findings informed changes in clinical practice for post-grommet follow- up and the successful development of an Advanced Audiology Practitioner (AAP) model. Subsequently, a school based, Specialist in the Community model was piloted in a South Auckland special character school. These models have potential to transform ear and hearing healthcare for children at risk for OME and hearing loss.