Five Tips to Position Your Practice for Success with Aural Rehabilitation



Author: Dusty Jessen, Au.D.

My interest in audiology began before I was even aware of the profession. My mom has what I would later diagnose as a moderate to profound unilateral loss. As kids will do, my brother and I used to tease her about it, but we also learned early to sit on her “good” side, if we had something important to say. In high school and college I spent several weekends volunteering at a nearby Easter Seals camp for adults with disabilities. Several of our campers wore hearing aids and I was fascinated by the technology that helped these people communicate. However, my final push into the profession was spending time with my step-grandmother who was one of the first people in the United States to receive bilateral cochlear implants. She did remarkably well, but her progressive improvement in communicating was what really had me intrigued. It was obvious that the technology did its part, but I could see that there was more involved; that the treatment was a process, rather than a device. It was this process that drew me into the field of audiology, and piqued my interest in aural rehabilitation.

I double-majored in audiology and speech-language pathology and minored in special education at the University of Northern Colorado. I earned my Master’s in audiology at Arizona State University and my Doctorate through A.T. Still University. For the past 13 years I have been the Director of Audiology in a small, yet busy Colorado ENT clinic. I operate the audiology side of the practice as its own entity, Columbine Audiology, Inc. I’m lucky to work for an otolaryngologist who recognizes the importance of early intervention of hearing loss, and we work as a team to educate our adult patients about the detrimental effects of untreated hearing loss. My position also allows me the freedom to test various aural rehabilitation plans and processes with our patients. Over the years, I’ve tried various group classes and individual programs. I’ve used commercially available programs and put together my own handouts and workbooks. I suppose I’ve used the clinic as a kind of “private practice aural rehab lab.” I’ve learned what works, what doesn’t, what patients will comply with and what they simply will not do. I also focus on what I can fit into my busy schedule—a good aural rehab program cannot take too much time and effort. I’ve used this information to develop the 5 Keys Communication program, and I’m committed to helping other ENT and private practice clinics provide a comprehensive aural rehabilitation program that fits the confines of a busy private practice. Today’s evolving marketplace presents challenges and opportunities for audiologists. At the top of our list remains the need to set ourselves apart from the commodity options available to consumers today (internet sales and big-box stores).

It all starts with a plan. So, what is your plan? How will you show patients that the value they receive from you is greater than the value they might receive from your competition?

I hope your plan includes positioning. We need to position ourselves as experts in communication rather than experts in hearing. This means providing a complete aural rehabilitation program for each and every patient.

I know we don’t get paid for it, I know we don’t have time for it, and I know that most patients don’t want to comply with it! I’ve had to overcome these same challenges in my own practice over the past 12 years, and I’m excited to share with you what I’ve learned along the way. Here are five quick and easy tips that you can implement in your practice right away that will enable you to get an effective aural rehab program off the ground.
Tip #1: Ditch the “Hearing Aid Evaluation”
The HAE is an outdated acronym that needs to be replaced ASAP. It places all emphasis on hearing aids and does nothing to set us apart from those commodity options. I recommend changing the name of this initial evaluation to a Communication Needs Assessment (CNA). This is a much more accurate description of what we are actually evaluating, and it sets the stage for improved communication right out of the gate. Experts in our profession have been calling for this semantic change for many years. There is a 2007 Hearing Journal article authored by Dr. Robert Sweetow (Sweetow, 2007) that I encourage you to read. It introduces the concept of a functional communication needs assessment. This approach is needed more today, than ever before.

There are several options available for evaluating communication needs. The Spring 2015 edition of Audiology Practices featured an effective new tool for the assessment of communication needs called the Their Reported Assessment of Communication Ability (TRACA) and recently shortened to the Assessment of Communication Ability (ACA). This tool is now available to clinicians at no charge, and can be accessed at www.eartrak.com.

Train yourself and your support staff to call that first appointment a Communication Needs Assessment, and use an assessment tool that actually evaluates communication needs, and you’re on the road to positioning yourself as an expert in communication.
Tip #2: Use Your Local & National Resources
I know how hard it is to fit aural rehab into our hectic schedules. While I do advocate providing an individualized communication solution for every patient, I also think it is important to plug our patients into the amazing resources that may be available locally and are definitely available nationally.

Local Resources
University Group AR Classes

Are you located near a University with an Au.D. or SLP program? If so, they may be conducting group AR classes that are available to the public. Contact the clinical coordinator at the university to get the details. Not all patients will be interested in a group class, but some will be and it’s nice to have an option for them (that takes absolutely no time out of your schedule).

Local HLAA Chapters
There are hundreds of local chapters of the Hearing Loss Association of America. You can visit their website to find a local chapter in your area. Contact the president of your local chapter and get information on meeting times and events. Make sure you are on that chapter’s email list. Then share this information with every patient. Again, not all patients will be interested in participating, but I promise they will be impressed that you are providing them with options to learn and connect with other people who deal with similar frustrations.

National Resources
Hearing Loss Association of America

In my opinion, every single patient should be plugged into HLAA. Patients can become HLAA Members for just $35/year. As members, they receive many benefits including the bimonthly Hearing Loss Magazine which is a beautiful publication that is like an AR class and support group rolled into a colorful and inviting magazine. In our clinic, we actually purchase an annual HLAA Membership for each patient who purchases hearing aids. We list this as one of the many services they receive through our clinic, and it has been a wonderful investment!

There are many awesome resources available to our patients, so choose the ones that work for your clinic and your community, and make sure every single patient knows about them!
Tip #3: KISS (Keep It Super Simple)
Let’s face it, I’m busy, you’re busy, your patients are busy. We’re all busy! As clinicians we are inundated with phone calls, emails, product training, business training, staff meetings, etc. Our appointments are consumed with testing, fitting, verifying, and educating on the use of hearing aids, batteries, chargers, wireless devices, etc.

Where in the world do we find the time to teach our patients appropriate expectations, speech reading, coping mechanisms, and effective communication strategies? And will our patients (and their family members) really read a long book or a big packet of information about this when they leave our office? Nope!

That’s why it is so incredibly important to KISS (Keep It Super Simple). Use resources that are easy for you to teach and easy for your patients to learn and remember. The IDA Institute has fantastic resources and it is free to become a member of their community. The 5 Keys to Communication Success patient handbook was written to be short, simple, and efficient (download a free sample copy at www.5keys.org). The 5 Keys provide a very simple structure that is easy for patients to remember and share with their loved ones:



No matter what you choose, just make sure you are using something! Providing your patients with that extra education and training, beyond the hearing aids, is what sets you apart from your competition.
Tip #4: Personalize It
Today’s savvy patient doesn’t want to be stereotyped or placed in a bucket with everyone else. They don’t want a one-size-fits-all hearing aid or treatment plan (otherwise they’d have ordered hearing aids online). Make your practice stand out by providing a personalized treatment plan for each patient. Ask lots of questions, really listen to the answers, and plan your treatment around those specific needs. Be sure to include your patient’s communication partner in these plans because he or she is often the biggest problem in a communication breakdown.

But don’t forget to follow Tip #3 as you personalize your treatment! Simplicity is still key in getting our patients to comply with our recommendations. Here’s a simple tool we use to personalize our treatment plan and involve the communication partner:



The Successful Communication Plan is a simple way to help patients create a personalized action plan for each of their challenging communication situations. Obviously this plan follows the 5 Keys to Communication Success as they are taught in our handbook (and they are included throughout the handbook). However, you can create a personalized plan based on any educational approach you choose to use with your patients. The Successful Communication Plan is available to anyone who wants to use it by going to www.5keys.org/in-the-news/resources

Write it down! Make sure you are providing a written version of their personalized plan, because patients are so overwhelmed by the technical aspects of new hearing aids that they simply won’t remember the communication strategies we provide them verbally. These communication strategies are absolutely critical to their success, and this personalized education is what sets us apart from the competition, so find a system that works for you and start using it today.
Tip #5: Consistent and Long-Term Follow Up Creates Long-Term Satisfaction
It is no secret that patient follow up is critical. Our patients simply won’t retain all of the information we provide them during their trial period. This is especially true when it comes to learning effective communication strategies. It takes 30-90 days to create a habit, and our patients need consistent reinforcement as they are learning to implement new effective communication habits.

Let’s take a look at the pros and cons of 3 different follow-up methods:

Phone Calls
  • Pros
    • nice personal touch - make patients feel special
    • good option if you have support staff who can make the calls
  • Cons
    • time consuming
Newsletters (via snail mail)
  • Pros
    • nice personal touch
    • outside companies can do this for you
    • good option for annual, semi-annual or quarterly contact
  • Cons
    • time consuming (if doing yourself)
    • expensive (especially if sending more frequently)
    • rain forests are disappearing at alarming rates...do we really want to contribute to that?
e-Newsletters (via e-mail)
  • Pros
    • majority of our patients have e-mail accounts
    • minimal expense
    • environmentally friendly
    • can send frequently
    • outside companies can do this for you (hint hint:)
    • patients can share on social media or forward to friend, family member, or co-worker
  • Cons
    • some patients may not have e-mail accounts
    • some patients may feel like they receive too many e-mails
The 5 Keys Communication Program includes weekly eTips that are emailed directly to the patient for an entire year. Simply hand your patient a Subscription Postcard and instruct them to claim their free gift by following the instructions on the postcard. We take care of the rest! Each eTip is structured to provide:
  • a reminder about a specific communication strategy
  • a “homework” assignment to help them apply that strategy in their own lives
  • a helpful hearing aid tip
  • a reminder to return to their hearing care provider with any questions or concerns (this critical part keeps YOU at the top of your patients’ minds every single week)
Which method is right for you? Perhaps a combined approach will have the greatest impact. Regardless of the method you choose, it is critical that you are providing some kind of long-term education and follow up care. This reduces returns and increases patient satisfaction and patient referrals. It is a MUST for every practice who wants to stand apart from the competition.



Obviously there are many ways we can set ourselves apart from the commodity options available to consumers today. Following best practices, providing patient- centered care, and creating an excellent patient experience are all critical components of a successful practice. Aural rehabilitation is the treatment side of each of these areas, and should be prioritized every step of the way. The five simple tips discussed here are just the tip of the iceberg when it comes to aural rehabilitation. I believe they should be applied to each and every patient, regardless of his/her degree of loss or experience with amplification. It is important to note that there are many patients who need more. Auditory training (computerized or clinician directed) is an important component of aural rehabilitation that also needs to be considered and applied on a per-patient basis. But that, my friends, is a discussion for another day!    
Dr. Jessen earned her master’s from Arizona State University, and her doctorate from AT Still School of Health Sciences. She has been the Director of Audiology in a busy Denver area ENT clinic since 2003. In 2013, she published her critically-acclaimed book, Frustrated by Hearing Loss? 5 Keys to Communication Success, which is the foundation for her company’s unique Cut to the Chase Counseling approach to patient education. Dr. Jessen can be contacted at support@5keys.org. Her aural rehabilitation website is http://5keys.org.