Hearing Impairment, Strategies, and Outcomes in Emergency Departments
Phase: NA
Conditions: Hearing Loss, Emergency Service, Hospital Readmission
Sponsor: VA Office of Research and Development

Protocol At-A-Glance 
 
 
 
 
 
 
Version 2018.10.18. 
 
Project Title: Hearing Impairment, Strategies and Outcomes in VA Emergency Departments 
Principal Investigator: Joshua Chodosh, MD, MSHS 
Site: 630 – New York Harbor Healthcare System 
 
Study Goals: 
1) Establish the feasibility of screening for hearing loss in the ED 
2) Determine the acceptability of the screening procedure (among ED population) 
3) Derive a preliminary estimate of effect size of primary outcomes 
4) Identify the evidence that decision makers in VAMCs, ED and Audiology Services need to commit to this approach 
 
Study Outline: 
-18 month funding period, to include: four month start-up, 12 months of intervention, and two months of analysis, 
disseminations, and plans for next steps to advance hearing healthcare in VA health system 
-Minimum goal of 68 and maximum is 150 (across both Manhattan and Brooklyn) 
-Patients will be randomized to receiving a HAD or control 
-Data collections from VA CPS, RA observations, 10-minute RA survey, and brief qualitative follow-up interviews with 
patients, nurses, physicians. Follow-up calls three-days and 30-day ED visits will occur. 
-Brief semi-structured interviews with 10 veterans willing to speak more extensively after discharge from ED 
-Brief semi-structured interviews with 10 nurses and physicians (providers) will access their experiences with the 
hearing-impaired patients 
 
Milestones/Developmental Progress Goals (DPGs): 
We will track and report on these Milestones regardless of your decision about the feasibility of continued support 
beyond the 18---month period. 
 
Hiring and training of research staff 
 
Successful recruitment of at least 68 subjects who consent to hearing screening in the Emergency Department 
 
Completion of the HHIE for 85% of consented patients 
 
Delivery and fitting of the PockeTalkerTM for 85% of patients who score > 10 on the HHIE 
 
Completion of the HAD use survey for 70% of patients who are given PockeTalkersTM 
 
Completion of the 6---item measure of quality of hearing, understanding, and communication for 70% 
 
Completion of the CTM---3 for these same 70% 
 
Successful pilot test of the Patient Understanding of Discharge Instructions (PUDI) for 10 subjects 
 
Completed semi---structured interviews these 10 subjects and research staff to assess feasibility and refine 
processes 
 
Completion of three virtual advisory council meetings with 70% attendance 
 
Preparation of a summary report of these virtual meetings addressing key issues of feasibility/implementation 
 
Demonstration of feasibility for all aspects of screening process and delivery, fitting, and teaching PockeTalkerTM 
use through observed time/effort, proportion of completed assessments, and patient/provider feedback. 
 

Protocol At-A-Glance 
 
 
 
 
 
 
Version 2018.10.18. 
 
 
Table 5: Project activities and timeline
Tasks:
Q3
Q4
Q1
Q2
Q3
Q4
Hiring and training
Subject materials preparation
Obtain IRB approval
Build survey tool
Subject recruitment / consent
Intervention / usual care study period
Subject post-ED visit survey/interview
Subject (physician) interviews
Medical record data extraction 1
Conduct qualitative analyses
Conduct data analyses
Write final report
Conduct advisory / stakeholder meetings
Presentations for dissemination
Q1 = Quarter 1, etc                            
1Adminstrative data of all consented subjects on visit and diagnostic variables
FY 2018
FY 2019