Abstract
Background
Unaccommodated hearing loss can impede effective communication during hospitalization, contributing to disparities in care and adverse outcomes. Prior research demonstrates unreliable documentation of hearing impairment in the electronic health record (EHR) and limited accommodations. This quality improvement study evaluated the quality of EHR documentation of hearing impairment in hospitalized patients as well as provider perspectives on communication barriers.
Methods
We conducted a mix methods study in which we reviewed EHR documentation for patients ≥65 years discharged from Medicine, Geriatrics, and Surgery services between June 2023 and June 2024 at a 1000 bed academic medical center and affiliated community teaching hospital. We also performed a small survey of inpatient medicine providers on perceived barriers to communication with hearing-impaired patients.
Results
Among 7,481 encounters, 31.4% had documentation of hearing impairment, primarily from nursing activities of daily living (ADL) screens. Documentation differed across EHR locations and showed limited concordance.
Conclusions
Findings highlight inconsistent, unreliable documentation of hearing impairment, limited device availability, and substantial communication barriers, underscoring the need for standardized inpatient screening and support strategies for hospitalized patients with hearing impairment.