Developmental Dysplasia of the Hip Multidisciplinary Outreach Education
Aims
- To establish a baseline model of care for the screening, assessment and management of Developmental Dysplasia of the Hip (DDH) across Hunter New England Area Health Service (HNEAHS) that is consistent with best practice guidelines.
- To enhance the consistency of service provision for infants and children with DDH across HNEAHS
- To enhance access for infants / children to optimal assessments and intervention for DDH closer to home. This is in line with recommendations from the Garling Inquiry (2008), NSW State Health Plan (2006); NSW State Plan (2006); National Health and Hospitals Reform Commission (2008) and Children and Young People’s Health Priority Taskforce (2008).
- To establish links and enhance collaboration between medical, nursing and allied health professionals across HNEAHS in relation to the management of neonatal orthopaedics.
- To provide opportunities for professional development in the area of neonatal orthopaedics for staff in regional and rural areas.
Method
- Employ a 0.2 FTE project officer over a 18-month period to undertake a stakeholder needs analysis, to evaluate existing services and service needs, to facilitate the development and implementation of a multidisciplinary outreach education program, to facilitate the development of a standardised Clinical Practice Guideline for the screening, assessment and management of DDH across HNEAHS, to undertake a post-project review and develop a project report.
- Complete stakeholder needs analysis, evaluate existing hip screening processes across HNEAHS, and collect data regarding birth rates, incidence of infants detected with DDH at birth and number of late presentations.
- Create a multidisciplinary education program to target the needs of the various stakeholder groups.
- Present 6 multidisciplinary DDH outreach education sessions at regional and rural sites across NCHN, conducted by a Paediatric Orthopaedic Specialist, a Physiotherapist, and a Paediatric Radiologist.
- Development of a standardised Clinical Practice Guideline for the screening, assessment and management of DDH for HNEAHS based on stakeholder needs analysis, outreach education evaluations and consumer feedback.
- Identify key stakeholders from each area to be involved in a Neonatal orthopaedic interest group to provide consultation and feedback regarding guidelines, pathways and issues.
- Trial implementation of the guidelines across HNEAHS
- Evaluation and recommendations.
Key performance indicators
The success of the project will be measured by:
- Evidence of enhanced consumer satisfaction as demonstrated by increased numbers of infants with DDH being managed at sites closer to their home / community proven by surveys at the beginning and end of the project period
- Reduction in the number of babies being identified with DDH after the age of 3 months as shown in data analysis
- Reduction in the number of babies requiring surgical intervention due to late detection of DDH as shown in data analysis
- Development of an outreach education package
- Completion of 6 outreach education programs in regional and rural areas across HNEAHS
- Development of a standardised clinical practice guideline / pathway for the screening, assessment and management of DDH across HNEAHS.
Progress
- Project complete.
- Documents developed & resources identified for the detection of DDH:
- Clinical Practice Guideline - Hunter New England Health (pdf 279K)
- Clinical Practice Guideline Resource Manual (pdf 253K)
- Clinical pathways
- Birth - before discharge from hospital (pdf 17K)
- Child and Family Health Nurses (pdf 18K)
- General Practitioners (pdf 20K)
- Fact Sheet (pdf 306K)
- Learning resources (produced by Royal Children's Hospital Melbourne)
- Questionnaires were distributed to parents of children accessing the hip clinic at JHCH. Changes in consumer satisfaction, as a result of outreach education and implementation of the clinical practice guideline, could not be monitored within the project timeframe.
- Data continues to be collected regarding late presentation cases of DDH who access services through JHCH. The data suggests that the number of babies being diagnosed after 3 months of age is variable from year to year. There is a number of factors that may influence this data. Consultation with the clinical improvement team at JHH has been undertaken to investigate the possibility of pulling population data from the 3 tertiary children’s services within NSW to determine reliable incidence data, over time, from within HNEAHS. Reliable data could not be obtained from JHCH or statewide due to inconsistent coding of patients with DDH. Hence, data for the support of this KPI was not possible.
- An outreach education package was put together by experts from JHCH and utilised at the 6 outreach education sessions that were held throughout 2010 across HNEAHS and NCAHS.
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Outreach Education programs were run in:
- Taree
- Maitland
- Tweed Heads
- Armidale
- Coffs Harbour
- Port Macquarie
- The clinical practice guideline entitled ‘Screening, Assessment and Management of Developmental Dysplasia of the Hip (DDH)’ was approved for use across HNEAHS in December, 2010. This guideline has been distributed among clinicians and is available on the Kaleidoscope, NCHN and HNEAHS websites.
For more information contact:
Jenny Martin
Director Allied Health KGNS
Phone: 02 4921 4377