Best Practices
Best practices describe a set of procedures that should be followed during hearing assessment, hearing aid selection, hearing aid fitting, and long-term hearing care. Following these procedures has been shown to improve patient outcomes.
An example of a set of best practices comes from the American Speech and Hearing Association (ASHA). They recommend the following ten practices:
Develop a comprehensive treatment plan.
Use a patient-focused “income” measure.
Use meaningful clinical tests.
Establish patient-specific treatment goals.
Select hearing aid features on the basis of the treatment goals, not the audiogram.
Verify the hearing aid performance parameters with test box and probe microphone measures.
Validate your treatment plan.
Evaluate for and prescribe hearing assistive technology (HAT), as appropriate.
Itemize your fees. Bundling is a practice that obscures your professional value and implies a product purchase, not payment for professional services.
Provide post-fitting aural rehabilitation services.
Real ear measurement is used to verify that hearing aids are fit to prescriptive targets
You might assume that this is irrelevant for you, because every clinic should follow best practices for hearing care. Unfortunately, this doesn’t seem to be the case. Many clinics seem to be focused primarily on the process of dispensing hearing aids, but not necessarily using best practices in doing so. Clark et al. (2017) surveyed audiologists from the American Academy of Audiology. They found that many best practices are not followed by the majority of providers:
Only 15% of audiologists were routinely using self-assessment measures of hearing
Only 15% of audiologists were doing speech-in-noise testing
Only half of audiologists were doing probe-microphone measurements to verify hearing aid fittings
Only half of audiologists were discussing hearing assistive technology with patients
Few audiologists were discussing communication strategies, auditory training, and aural rehabilitation with patients
Hearing aid accessories and assistive listening devices can improve communication in difficult environments
As a patient, this means that your quality of care will be influenced by the clinic that you choose to work with. For optimal outcomes with hearing care, you need to be informed about where you are going, the clinician you are seeing, and the services that are being provided.
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Reference
Clark JG, Huff C, Earl B. Clinical practice report card: Are we meeting best-practice standards for adult hearing rehabilitation. Audiology Today. 2017; 29(6):15-25.