Michelle Pokorny
Advanced Audiologist, Te Whatu Ora Counties Manukau, Auckland, NZ
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Michelle is a clinical audiologist researcher with an interest in public health and service re-design. She holds an HRC CPRF (2024). Her research interests include addressing inequities in hearing and ear care, development of innovative services, technologies and tools to provide effective, efficient and sustainable improvements in clinical care.
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Inequity in Outcomes after Grommet Insertion as a Driver for Innovation in Ear and Hearing Service Delivery
Authors List
Pokorny, MA, Te Whatu Ora, Counties Manukau, Audiology and ORL Department, Auckland, NZ
MacFater, W, Te Whatu Ora Waikato, ORL Department, Hamilton, NZ
Holt, E, Section of Audiology, Faculty of Medical and Health Sciences, School of Population Health, The University of Auckland, Department of Audiology, Auckland, NZ
Fuller H, Section of Audiology, Faculty of Medical and Health Sciences, School of Population Health, The University of Auckland, Department of Audiology, Auckland, NZ
Mahadevan M1, Te Whatu Ora, Counties Manukau, Audiology and ORL Department, Auckland, NZ
Thorne PR, Section of Audiology, Faculty of Medical and Health Sciences, School of Population Health, The University of Auckland, Department of Audiology, Auckland, NZ
Aims
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. Two innovative practice models developed in South Auckland to improve delivery of ear and hearing healthcare will be described.
Methods
89 children from South Auckland were recalled for audiology assessment and functional health questionnaire (OMQ20) two years after grommet insertion. Semi-structured interviews were conducted with 28 whānau/families to explore perceptions and preferences. The two innovative practice models (the Advanced Audiology Practitioner (AAP) service for children with OME and the school-based Specialist in the Community (SinC) model) were piloted in South Auckland.
Results
Two years after routine grommet insertion, most (51.7%) children had hearing loss in one or both ears, but Māori children were significantly more likely (5.145 odds ratio) to have bilateral hearing loss (56.5%) compared to non-Māori children (22.7%; p=.004). 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. The AAP service significantly improved access to grommet surgery (increased capacity, reduced wait times and high engagement) particularly for Māori and Pacific children. The SinC model bridged the gap between community and access to specialist services in the pilot school.
Conclusions
Overall, findings show poor hearing and functional health outcomes within two years of grommet surgery despite whānau indicating engagement with their children's development and having high expectations of follow-up services. Ear and hearing services must adapt to address the inequities that persist. Both the AAP and SinC models have potential to transform ear and hearing healthcare for children at risk for OME and hearing loss.
Pokorny, MA, Te Whatu Ora, Counties Manukau, Audiology and ORL Department, Auckland, NZ
MacFater, W, Te Whatu Ora Waikato, ORL Department, Hamilton, NZ
Holt, E, Section of Audiology, Faculty of Medical and Health Sciences, School of Population Health, The University of Auckland, Department of Audiology, Auckland, NZ
Fuller H, Section of Audiology, Faculty of Medical and Health Sciences, School of Population Health, The University of Auckland, Department of Audiology, Auckland, NZ
Mahadevan M1, Te Whatu Ora, Counties Manukau, Audiology and ORL Department, Auckland, NZ
Thorne PR, Section of Audiology, Faculty of Medical and Health Sciences, School of Population Health, The University of Auckland, Department of Audiology, Auckland, NZ
Aims
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. Two innovative practice models developed in South Auckland to improve delivery of ear and hearing healthcare will be described.
Methods
89 children from South Auckland were recalled for audiology assessment and functional health questionnaire (OMQ20) two years after grommet insertion. Semi-structured interviews were conducted with 28 whānau/families to explore perceptions and preferences. The two innovative practice models (the Advanced Audiology Practitioner (AAP) service for children with OME and the school-based Specialist in the Community (SinC) model) were piloted in South Auckland.
Results
Two years after routine grommet insertion, most (51.7%) children had hearing loss in one or both ears, but Māori children were significantly more likely (5.145 odds ratio) to have bilateral hearing loss (56.5%) compared to non-Māori children (22.7%; p=.004). 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. The AAP service significantly improved access to grommet surgery (increased capacity, reduced wait times and high engagement) particularly for Māori and Pacific children. The SinC model bridged the gap between community and access to specialist services in the pilot school.
Conclusions
Overall, findings show poor hearing and functional health outcomes within two years of grommet surgery despite whānau indicating engagement with their children's development and having high expectations of follow-up services. Ear and hearing services must adapt to address the inequities that persist. Both the AAP and SinC models have potential to transform ear and hearing healthcare for children at risk for OME and hearing loss.
