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Standardized Process Measures in Radiographic Hip Surveillance for Children with Cerebral Palsy
Detection of hip migration in children with cerebral palsy (CP) through radiographic surveillance can prevent dislocations. Migration Percentage (MP) is the accepted method for quantifying hip subluxation in CP on pelvis x-ray but was not being reported at our institution. Our objective was to impro...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8677969/ https://www.ncbi.nlm.nih.gov/pubmed/34934874 http://dx.doi.org/10.1097/pq9.0000000000000485 |
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author | Milks, Kathryn S. Mesi, Erin L. Whitaker, Amanda T. Ruess, Lynne |
author_facet | Milks, Kathryn S. Mesi, Erin L. Whitaker, Amanda T. Ruess, Lynne |
author_sort | Milks, Kathryn S. |
collection | PubMed |
description | Detection of hip migration in children with cerebral palsy (CP) through radiographic surveillance can prevent dislocations. Migration Percentage (MP) is the accepted method for quantifying hip subluxation in CP on pelvis x-ray but was not being reported at our institution. Our objective was to improve care for children with CP by standardizing radiographic techniques and reporting radiographs obtained as part of a hip surveillance program. METHODS: A baseline retrospective review of CP surveillance pelvis x-ray reports was performed. We then educated radiologists and technologists, standardized imaging techniques, and required structured radiology reporting to include MP measurement and dislocation risk categories. We tracked compliance with the reporting template for 10 months. Images and reports were also assessed for quality and accuracy by an orthopedic surgeon. RESULTS: Baseline period reports showed no consistency. In total, 449 children with CP (mean age: 7.3 years ± 4.2) had a surveillance pelvis radiograph during the postintervention study period (May 2019–February 2020). An estimated 90% reporting compliance was achieved and sustained by 5 months. Eight (89%) of the children with high-risk hips were newly diagnosed during our study period; all had a progressive increase in MP from prior examinations. All clinicians surveyed agreed that the standardized reports, including MP, were helpful to their practice. CONCLUSIONS: Using evidence-based process measures and quality improvement methodology, we standardized hip surveillance for children with CP. Radiology reports that include MP and risk category for hip dislocation enable clear communication for referrals across specialties and early detection and treatment for better outcomes. |
format | Online Article Text |
id | pubmed-8677969 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-86779692021-12-20 Standardized Process Measures in Radiographic Hip Surveillance for Children with Cerebral Palsy Milks, Kathryn S. Mesi, Erin L. Whitaker, Amanda T. Ruess, Lynne Pediatr Qual Saf Individual QI projects from single institutions Detection of hip migration in children with cerebral palsy (CP) through radiographic surveillance can prevent dislocations. Migration Percentage (MP) is the accepted method for quantifying hip subluxation in CP on pelvis x-ray but was not being reported at our institution. Our objective was to improve care for children with CP by standardizing radiographic techniques and reporting radiographs obtained as part of a hip surveillance program. METHODS: A baseline retrospective review of CP surveillance pelvis x-ray reports was performed. We then educated radiologists and technologists, standardized imaging techniques, and required structured radiology reporting to include MP measurement and dislocation risk categories. We tracked compliance with the reporting template for 10 months. Images and reports were also assessed for quality and accuracy by an orthopedic surgeon. RESULTS: Baseline period reports showed no consistency. In total, 449 children with CP (mean age: 7.3 years ± 4.2) had a surveillance pelvis radiograph during the postintervention study period (May 2019–February 2020). An estimated 90% reporting compliance was achieved and sustained by 5 months. Eight (89%) of the children with high-risk hips were newly diagnosed during our study period; all had a progressive increase in MP from prior examinations. All clinicians surveyed agreed that the standardized reports, including MP, were helpful to their practice. CONCLUSIONS: Using evidence-based process measures and quality improvement methodology, we standardized hip surveillance for children with CP. Radiology reports that include MP and risk category for hip dislocation enable clear communication for referrals across specialties and early detection and treatment for better outcomes. Lippincott Williams & Wilkins 2021-12-15 /pmc/articles/PMC8677969/ /pubmed/34934874 http://dx.doi.org/10.1097/pq9.0000000000000485 Text en Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Individual QI projects from single institutions Milks, Kathryn S. Mesi, Erin L. Whitaker, Amanda T. Ruess, Lynne Standardized Process Measures in Radiographic Hip Surveillance for Children with Cerebral Palsy |
title | Standardized Process Measures in Radiographic Hip Surveillance for Children with Cerebral Palsy |
title_full | Standardized Process Measures in Radiographic Hip Surveillance for Children with Cerebral Palsy |
title_fullStr | Standardized Process Measures in Radiographic Hip Surveillance for Children with Cerebral Palsy |
title_full_unstemmed | Standardized Process Measures in Radiographic Hip Surveillance for Children with Cerebral Palsy |
title_short | Standardized Process Measures in Radiographic Hip Surveillance for Children with Cerebral Palsy |
title_sort | standardized process measures in radiographic hip surveillance for children with cerebral palsy |
topic | Individual QI projects from single institutions |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8677969/ https://www.ncbi.nlm.nih.gov/pubmed/34934874 http://dx.doi.org/10.1097/pq9.0000000000000485 |
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