The Patient Rehabilitation Pathway

Up to now the following information is available for end users in three countries: the United Kingdom (UK), Germany (DE) and the Netherlands (NL). However, the goal is to develop a framework that may be expanded to accommodate other countries in the future.

A number of stages are common to most patients as they undergo hearing rehabilitation. The rehabilitation journey of any patient - from when they first expressed concern regarding their hearing - can be mapped using a variable number of defined steps. These steps will be referred to as the Patient Rehabilitation Pathway. Although some inter-country variation occurs in the activities and processes that occur within each stage of the pathway – the overall total rehabilitative procedure and patient-professional contact is usually very similar. The core stages in aural rehabilitation – applicable to all three countries – are as follows:

  • Screening:
    This stage can be defined as the process of checking for hearing impairment when there are no physical symptoms – taking an online or telephone hearing check, for example. It can also refer to the process of visiting a GP or hearing aid dispenser to express concern regarding one’s hearing and to see whether those concerns are justified.
  • Hearing Assessment:
    Where the patient is subject to audiological investigation, usually involving a suite of common hearing tests such as pure-tone audiometry and speech-in-noise testing – as well as middle ear impedance tests such as tympanometry and acoustic reflex threshold testing.
  • Fitting:
    Where the patient is provided with a hearing device, which is then manually programmed in order to match the patient’s hearing requirements and compensate for their hearing loss as much as possible.
  • Trial period:
    During which time the patient is given the opportunity to become accustomed to their hearing device at home.
  • Follow up assessment:
    In which the patient returns to the hearing professional to assess the outcomes of the trial period. Based on the result of this assessment, the user may or may not be provided with a different hearing device to trial, or may or may not have their current device fine-tuned.
  • Aftercare:
    This term refers to the period in which the patient has been successfully fitted with a hearing device and no further appointments are scheduled. The patient may of course – at their own discretion – ask to see a professional again at a later date, should the need arise. It is also during this period that a patient may wish to consult a hearing therapist for advice on enhancing communication and information about assistive technologies.

These six core stages (illustrated in Figure below) will be used to provide the main rehabilitation pathway framework for all countries; however the exact processes that occur as part of each stage will vary from country to country.


Generic Rehabilitation Pathway
* Pathway stage may not be formally recognized within the protocols of all countries


Read on: Rehabilitation Pathway in the Netherlands, United Kingdom, Germany or read about Good Practice Procedures ...