The universal newborn hearing screening (UNHS) program started in UKM Medical Centre since April 2003 till now. More than 35,000 newborn were screened for hearing loss using portable otoacoustic emission (OAE) before they discharge. The joint Committee on Infant Hearing (JCIH) year 2000 position statement recommends some quality indicators for UNHS which include achieving a screening rate of at least 95% within 6 months of program initiation, referral rate to no greater than 4% and achieving return for follow up rate of at least 70%. After the first stage hearing test perform by the staff nurse, the result from test can be kept in quickly and efficiently. Babies who fail the first stage screening test will be given the appointment date by the staff nurse without calling the ORL Clinic officer. Those failed screening test need to come for follow up with Automated Brain stem evoked response(AABR) at 6 week of life.During this stage the Assistant lab officer will keep in the result.At the same day the baby will go for brain stem evoked response if they failed the AABR test.