{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T04:35:25Z","timestamp":1777523725580,"version":"3.51.4"},"reference-count":19,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2021,7,8]],"date-time":"2021-07-08T00:00:00Z","timestamp":1625702400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To evaluate and increase adherence to an evidence-based audiologic management protocol for children with cleft palate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Prospective, multidisciplinary quality improvement initiative.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Tertiary pediatric hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients, Participants:<\/jats:title>\n                    <jats:p>Children with cleft palate (with or without cleft lip) between the ages of 0 and 5 years (n = 205).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions:<\/jats:title>\n                    <jats:p>A multidisciplinary team identified key drivers for nonadherence to recommended audiological follow-up and implemented interventions to improve adherence. Key drivers included provider practices and preferences, clinic logistics and flow, and patient\/family awareness and education. Several interventions were implemented between 2016 and 2020, including developing an evidence-based audiologic protocol, maximizing access to audiologic clinic visits across multiple departments, cleft team education, and improved team communication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure(s):<\/jats:title>\n                    <jats:p>Completion of recommended audiologic assessment at 5 separate care milestones.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>After implementation of interventions between 2016 and 2020, adherence to recommended audiologic follow-up increased from 59% to 84%. Analysis of individual care milestones revealed that increased access to audiologic testing during team clinics resulted in the largest increase in adherence to recommended follow-up. Additionally, cause-effect analysis revealed that nonadherence due to provider-related causes decreased over the project period to a greater extent than patient\/family-related causes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Implementation of an evidence-based audiologic care protocol and improvements in access to early hearing care are feasible in a high-volume multidisciplinary cleft clinic. Adherence to recommended audiologic management can be improved by establishing strategies to improve access to care, team member and family education, and enhanced team communication.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656211029526","type":"journal-article","created":{"date-parts":[[2021,7,8]],"date-time":"2021-07-08T05:23:21Z","timestamp":1625721801000},"page":"961-969","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Assessing Adherence to Audiologic Parameters of Care for Children With Cleft Palate: A Quality Improvement Initiative"],"prefix":"10.1177","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8971-0700","authenticated-orcid":false,"given":"Ursula M.","family":"Findlen","sequence":"first","affiliation":[{"name":"Audiology Department, Nationwide Children\u2019s Hospital, OH, USA"},{"name":"Department of Otolaryngology, Head &amp; Neck Surgery, The Ohio State University Wexner Medical Center, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Grischkan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head &amp; Neck Surgery, The Ohio State University Wexner Medical Center, OH, USA"},{"name":"Department of Pediatric Otolaryngology, Nationwide Children\u2019s Hospital, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra","family":"Alston","sequence":"additional","affiliation":[{"name":"Audiology Department, Nationwide Children\u2019s Hospital, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren","family":"Durinka","sequence":"additional","affiliation":[{"name":"Audiology Department, Nationwide Children\u2019s Hospital, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4148-4729","authenticated-orcid":false,"given":"Adriane","family":"Baylis","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Nationwide Children\u2019s Hospital, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,7,8]]},"reference":[{"key":"e_1_3_2_2_1","unstructured":"American Cleft Palate-Craniofacial Association. Parameters for evaluation and treatment of patients with cleft lip\/palate or other craniofacial anomalies. Cleft Palate-Craniofacial J. 2018;30(suppl 1)."},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1976.00780130059005"},{"key":"e_1_3_2_4_1","volume-title":"Audiology clinical practice guideline- cleft palate\/ craniofacial and syndromic patients (website version)","author":"British Columbia Children\u2019s Hospital (BCCH)","year":"2012","unstructured":"British Columbia Children\u2019s Hospital (BCCH). Audiology clinical practice guideline- cleft palate\/ craniofacial and syndromic patients (website version). Published online 2012."},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-979275"},{"issue":"1","key":"e_1_3_2_6_1","first-page":"28","article-title":"Audiologic clinical practice patterns: infant assessment","volume":"5","author":"Findlen U","year":"2020","unstructured":"Findlen U, Schuller N. 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