Perspectives on the Profession: Tamala S. Bradham, Ph.D., CCC-A

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A pediatric audiologist for almost 20 years, Tamala S. Bradham, Ph.D., CCC-A, has worked in three prestigious institutions—University of South Carolina, Medical University of South Carolina, and now Vanderbilt. At Vanderbilt University School of Medicine, she is an assistant professor and the associate director of quality, protocols, and risk management for the Department of Hearing and Speech Sciences. Bradham is currently pursuing a Doctor of Health Administration in the Executive Program of Health Administration at the Medical University of South Carolina. She received a Ph.D. in speech and hearing sciences and an M.S. in audiology from the University of South Carolina, and a B.A. in mathematics from Columbia College.

 Bradham

 

Tell us about your work in the field of hearing loss and what brought you to the work you are doing today.  Why and how did you become interested in the field of cochlear implants, early intervention, and (re)habilitation?

For the past 20 years, I have had the distinct pleasure of working with caring families and committed colleagues who all wanted what was best and never settled for less.  My course as an audiologist, however, has not been a traditional one.  Early on in my career, I worked almost exclusively with school aged children with auditory processing disorders and retired military service personnel and their families at the local Veteran’s Administration hospital.  Then, I met K. Todd Houston, while we were both working on our doctoral degrees at the same university.  He shared with me information about this organization for adults with hearing loss and their unwavering dedication to helping families who have children with hearing loss called the Alexander Graham Bell Association for the Deaf and Hard of Hearing and I was hooked!  

Under Houston’s leadership, we started an AG Bell chapter in South Carolina, a multidisciplinary cochlear implant program, and a distinguished training program for speech-language pathology students wanting to specialize in auditory-verbal therapy and family centered care.  And, we finished our doctorate program at the same time (and on time)!  Since then, I have been a part of two other extraordinary clinical and academic programs:  Medical University of South Carolina and the National Center for Childhood Deafness and Family Communication at the Vanderbilt Bill Wilkerson Center.  

Through my professional experiences with Houston, a seed was planted about the potential of children with hearing loss. That fact provided me with a whole new perspective regarding what families can do for their children. I was also born with a hearing loss and I really wanted to help families navigate the often turbulent ocean of uncertainty.  Growing up with hearing loss and watching my family deal with a “headstrong, won’t take no” as a child, I can now as an adult reflect on the challenges they faced.  There were times of no answers, times when progress was slow or not at all, and times of “why didn’t I think of that!”  Time seemed to be moving very slow.  But if you think about it, the first multichannel cochlear implant came out in 1984, just 30 years ago!  Every year, we hear of new innovative technologies, new processing strategies and new intervention strategies.  Families have persevered, asked questions and challenged the status quo!  Professionals and researchers have listened and continue to shape and fine-tune. The goal is to deliver the right care, at the right time, right place and every time.  The objective is to always do better.  This is the definition of quality improvement.  This is what I do each and every day. 

 

What are you focused on right now: clinically and academically? 

My research includes quality improvement and outcomes in listening and spoken language. I am currently partnering with OPTION Schools, Inc., in a longitudinal prospective study on outcomes in listening and spoken language in very highly specialized educational programs for children who are deaf and hard of hearing. We are currently analyzing variables that impact outcomes on articulation, vocabulary, and language and have presented some of our preliminary findings at AG Bell and the American Speech-Language Hearing Association (ASHA).  

I have also recently just finished editing a book with Houston on Assessing Listening and Spoken Language in Children with Hearing Loss.  I had the privilege of collaborating with 22 amazing authors who were willing to share their knowledge and expertise on assessments.  

The other major project that I am focusing on is with the National Quality Forum (NQF) in which I serve as elected committee member of the Eye Care and Ears, Nose, and Throat Conditions. To date, they have endorsed 18 performance measures for accountability and quality improvement, of which three are related to Early Hearing Detection and Intervention (EHDI): hearing screening prior to hospital discharge, hearing evaluation by 3 months of age, and a signed Part C Individualized Family Service Plan before 6 months of age.  Although these are process measures, it is my hopes that we will see some outcome measures related to EHDI during my time with NQF.  

 

You have been involved with AG Bell over the years. Tell us about your involvement with the organization and how it informs your work at Vanderbilt.

My involvement with AG Bell started at the state level with helping Houston form the AG Bell South Carolina chapter in 1996.  I served as the editor for the “Speak Out” chapter newsletter and eventually became president of the chapter.  

The first big project I did with national AG Bell was in 2004 when I was a guest editor for the Technology Issue of Volta Voices.  I remember that I wanted this issue to not only have the professionals share their knowledge about cutting-edge technologies but I wanted the family perspective on using this technology and the impact on their lives.  I have served on several scholarship committees through the years reading heartfelt stories from families.  Along with other committee members, I had the daunting task of deciding who would be awarded—such a difficult task!  I wished I could have given everyone who applied a scholarship!  Most recently, I served as the moderator for the 2012 AG Bell Research Symposium and the chair of the advisory committee for the 2013 AG Bell Listening and Spoken Language Symposium.  

 

Tell us about your most recent involvement, as chair of the 2016 Convention program committee?

Having the opportunity to work with the dedicated AG Bell staff and all the volunteers is truly a rewarding and educational opportunity.  I love watching how it all comes together and the fabulous ideas provided by everyone involved to make this an extraordinary convention.  I am very excited about the theme for the convention, Hear in Denver:  Accelerating Progress, Advancing Opportunities!  Much of the foundation has been laid by the pioneers before us with innovative technologies, legislation for equality and access, research discoveries, and new clinical applications that open new doors for intervention.  While we celebrate the pioneers who laid a new course for us to follow, it is our time to accelerate progress, continue to lead change, and ultimately create opportunities for success! 

 

Tell us about your doctoral work, and how that may influence/inspire convention content for those who serve as administrators.

To answer this question, I need to give you some background.  I first start with a quote (that may or may not be) by Albert Einstein, n.d.:  “Insanity is doing the same thing over and over again but expecting different results.”

In health care, evidence strongly suggests that services rendered are not meeting the patients’ needs, are not based on the best scientific knowledge available, and are not provided in an efficient manner that minimizes costs, resources, and time (Berwick & Hackbarth, 2012).  As much as 21 percent to 47 percent of health care costs may be unnecessary, or even counterproductive, to improved health (Berwick & Hackbarth, 2012).  Many patients, doctors, nurses, and health care leaders are concerned that the care delivered is not, essentially, the care that should be received (Institute of Medicine [IOM], 2001).  So why do we keep doing the same thing over and over again?  Why are we so resistant to process improvement?  Why do we dislike change?  

Knowing of these issues, I felt that I had more to learn in order to continue to provide the best services for the families who seek health-related services.  I turned to the doctoral health administration executive program at the Medical University of South Carolina, College of Health Professionals, Department of Healthcare Leadership And Management.  I have successfully completed two years of fulltime coursework, passed comps this fall and am now working on my dissertation.  My classes in change management, health policy, leadership, and strategic planning have helped prepare me the inevitable changes that are coming in health care.  Learning about the science behind these administration tasks is essential to help ensure that the occurring changes create the opportunities for success and meaningful progress.

 

What are the major themes and concepts that will drive the convention program design and why? What inspired them?

Similar to what I mentioned above: this convention will be about hearing, acceleration of progress in each child’s development, and advancement of opportunity in all life areas because we are all learning, developing, and mastering new skill sets that positively impact us each day. This theme and concepts will be embodied across all convention activities.

 

Share your thoughts on how the convention inspires families. 

When I think of Denver and of Colorado, I immediately think of two things:  skiing and the Wild West gold rush stories I heard as a young girl.  While we won’t be skiing in June and July, I want you to know that the AG Bell Convention will be like finding gold.  The sessions will be informative.  You will meet other very successful, happy children, adolescents and adults who have hearing loss.  You will be able to ask questions that will help you to advance opportunities needed to reach your goals.  Your family and children will make new lifetime friends and feel empowered!


What can new and experienced professionals in the field of listening and spoken language gain from the convention?

The 2016 AG Bell Convention Hear in Denver:  Accelerating Progress, Advancing Opportunities will offer a wide selection of informative, cutting-edge and best practices sessions designed to address a pivotal moment in the history of health care service delivery.  We face many challenges in providing high quality services.  Professionals who are new to the field of listening and spoken language will have the opportunity to network, learn from experienced professionals and researchers, and meet with amazing families.  Experienced professionals, who face many challenges in providing high quality services, will find the opportunity to exchange ideas with colleagues, strategize on how to implement the new knowledge gained into their practice and community, and be inspired by the families they meet.

 

References

Berwick, D. M., & Hackbarth, A. D. (2012). Eliminating waste in U.S. health care. Journal of the American Medical Association, 307(14), 1513-1516. http://dx.doi.org/10.1001/jama.2012.362

Institute of Medicine (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, D.C.: National Academy Press. Retrieved from https://iom.nationalacademies.org/~/media/Files/Report%20Files/2001/Crossing-the-Quality-Chasm/Quality%20Chasm%202001%20%20report%20brief.pdf