Quality standard

Quality statement 4: Audiological assessment

Quality statement 4: Audiological assessment

Quality statement

People who have had bacterial meningitis or meningococcal disease have an audiological assessment within 4 weeks of being well enough for testing. [2012, updated 2024]

Rationale

Bacterial meningitis and meningococcal disease can cause severe or profound deafness. In many cases, cochlear implants can improve hearing. It is important that the audiological assessment takes place promptly, preferably before discharge from hospital, to allow for an urgent referral for cochlear implants if needed. This is because these devices are only fully effective if they are implanted within 6 months of the onset of bacterial meningitis or meningococcal disease.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly. Note that, in all cases, audiological assessment should preferably be carried out before discharge, however, it is acknowledged that this will not always be possible.

Process

a) Proportion of people discharged from hospital within 1 week of being diagnosed with bacterial meningitis or meningococcal disease who have an audiological assessment before being discharged or within 4 weeks of discharge.

Numerator – the number in the denominator who have an audiological assessment before discharge or within 4 weeks of discharge.

Denominator – the number of people discharged from hospital within 1 week of being diagnosed with bacterial meningitis or meningococcal disease.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records.

b) Proportion of people who were admitted to hospital for more than 1 week with bacterial meningitis or meningococcal disease who have an audiological assessment within 5 weeks of admission.

Numerator – the number in the denominator who have an audiological assessment within 5 weeks of admission.

Denominator – the number of people who were admitted to hospital for more than 1 week with bacterial meningitis or meningococcal disease.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records.

Outcome

Rates of cochlear implantation for severe or profound deafness caused by bacterial meningitis and meningococcal disease.

Data source: The British Cochlear Implant Group collects data on referral for, and receipt of, cochlear implants. It does not include the cause of deafness requiring referral for cochlear implants, this data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records.

What the quality statement means for different audiences

Service providers (secondary care services) ensure that systems are in place for people who have had bacterial meningitis or meningococcal disease to have an audiological assessment within 4 weeks of being well enough for testing.

Healthcare professionals (hospital doctors, including paediatricians) identify when people who have had bacterial meningitis or meningococcal disease are well enough for audiological assessment. They then carry out an assessment within 4 weeks, explaining to the person why prompt assessment is needed.

Commissioners ensure that they commission services in which people who have had bacterial meningitis or meningococcal disease have an audiological assessment within 4 weeks of being well enough for testing.

People who have had bacterial meningitis or meningococcal disease have a hearing assessment within 4 weeks of being well enough for the test. This is to make sure that, if they have severe or profound deafness caused by the illness, they can be urgently referred for cochlear implants which can help improve their ability to hear and understand speech.

Definitions of terms used in this quality statement

Well enough for audiological testing

People who are no longer critically ill should have an audiological assessment within 4 weeks, and preferably before discharge.

For measurement purposes, this could be:

  • before discharge from hospital or within 4 weeks of discharge, if the person was admitted for up to 1 week

  • within 5 weeks of hospital admission if the person was admitted for longer than 1 week.

[Adapted from NICE's guideline on meningitis (bacterial) and meningococcal disease: recognition, diagnosis and management, recommendation 1.12.7 and expert opinion]