Expect the unexpected: Lessons learned in Queensland during the AccuScreen device implementation

Mrs Delene Thomas1

Healthy Hearing Program, Queensland, Pullenvale, Brisbane, Australia

The Queensland Healthy Hearing Program are currently undertaking a state-wide transition from the Natus Algo  device to the AccuScreen device, with a third of hospitals live on the new device. Queensland is the first state in Australia to adopt the Otometrics – MADSEN AccuScreen as their state-wide device, a number of challenges have needed to be overcome.

Key strategies informing this equipment changeover involved  stakeholder engagement,  clinical evaluation trial, awareness of change management risks and challenges, developing new screener education and resources, maintaining program current low referral rates and modifying screening practice to suit the new device. Baseline comprehensive data was easily extracted from the Queensland QChild database supplying the current screening workforce numbers, devices in use, and state and local refer rates.

Unexpected higher refer rates have been a surprise challenge, and the adjustment phase back to meeting benchmark referral rates has taken longer than anticipated. In addition, learned habits regarding the baby alert / quiet state at screening have influenced the higher refer rates at new roll out sites, which has now been addressed and modified. Revisiting all new sites has been a beneficial strategy to observe what has gone well, and where improvement in technique or education can be targeted. Education resources and protocols are a “work in progress”, with amendments resulting from screener feedback reflect our combined and ongoing developing working knowledge of the device. Additional QChild data reports have been developed to monitor individual screener refer rates during the transition phase.

Other lessons learned involve managing screener expectation, challenges of technique differences, restoring  dip in screener confidence and restoration of pride and skill. In addition clear expectation of good screening practice to minimise false refers have been other challenges to master and overcome.


Delene has been involved with the Queensland Healthy Hearing Program since 2004 in the role of Screening Area Co-ordinator and has witnessed many changes over the past 13 years. Delene has a Nursing and Midwifery background and strongly supports Screener access to current evidence, relevant, contemporary and reliable training resources and clear protocols to build and maintain the fundamentals of a strong, competent and highly skilled workforce to screen Queensland babies.