Outcomes from 7 years of a direct to audiology referral pathway

• Published in: Irish journal of medical science Vol. 192; no. 3; pp. 1341 - 1347
• Main Authors: Katiri, Roulla, Sivan, Nina, Noone, Anthony, Farrell, Eric, McLoughlin, Laura, Lang, Bronagh, O’Donnell, Bronagh, Kieran, Stephen M.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-06-2023
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Ambulatory Care Facilities; Audiology; Family Medicine; General Practice; Hearing Aids; Humans; Internal Medicine; Medicine; Medicine & Public Health; Middle Aged; Original; Original Article; Otolaryngology; Referral and Consultation; Young Adult; Hearing assessment; Direct referral pathway; Otology; Tinnitus; Vertigo; Audiology
• ISSN: 0021-1265; 1863-4362
• DOI: 10.1007/s11845-022-03145-0

Background
The direct to audiology via ENT referral pathway was designed to enhance patient access to audiology services. The pathway is recommended in the Otolaryngology Head & Neck Surgery: a model of care for Ireland report, published in 2019.
Aims
This study aimed to review the outcomes of all patients that attended our institution over the last seven years.
Methods
A retrospective review of the direct to audiology referral service from March 2014 to December 2021 was conducted. Outcomes were defined by the pathway each patient took following attendance at the audiology clinic. Patients were either (i) discharged, (ii) referred for hearing aid(s) or (iii) identified as candidates for further diagnostic assessments, including a follow-up at the ENT outpatient clinic.
Results
During the time frame, 419 patients were triaged to the pathway. The average wait time was 13 days. The average age was 53 years (range 16–96 years, SD = 6.1). Approximately 34% (
n
 = 143) of all patients referred were discharged back to the GP by the audiologist, but 66% (
n
 = 276) presented with ‘red flags’ and needed further investigation in the ENT clinic, with 30% (
n
 = 73) ultimately requiring imaging studies. Over half (
n
 = 254, 61%) were referred for hearing aids.
Conclusion
The direct to audiology initiative has proven effective at reducing waiting times for ENT patients solely in need of audiological intervention. Approximately one-third of these referrals to the ENT service can be assessed comprehensively in the audiology clinic, thereby reducing the demand for ENT clinics, enhancing service provision and expediting onwards referral for amplification.