Implementation of a Ponseti Clubfoot Program Decreases Major Surgery: A Quality Improvement Initiative.
Journal
Pediatric quality & safety
ISSN: 2472-0054
Titre abrégé: Pediatr Qual Saf
Pays: United States
ID NLM: 101702480
Informations de publication
Date de publication:
Historique:
received:
12
12
2019
accepted:
12
08
2020
entrez:
12
2
2021
pubmed:
13
2
2021
medline:
13
2
2021
Statut:
epublish
Résumé
Clubfoot describes a congenital condition. If untreated, clubfoot can cause long-term functional issues. The Ponseti method is the gold-standard treatment; it emphasizes casting over surgery. We identified a high rate of major recurrence in patients with isolated clubfoot at our institution. We implemented a quality improvement intervention to address the recurrences. We established a clubfoot program that aimed to (1) develop a standardized treatment pathway; (2) improve care team education; (3) improve coordination of care with families; and (4) improve documentation. The purpose of this study was to outline our quality improvement intervention and evaluate its success. Data were retrospectively collected from isolated clubfeet before (2003-2007, phase I) and after (2012-2014, phase II) implementation of the clubfoot program. We compared the differences in treatment and major recurrence between the 2 phases using generalized logistic or linear mixed models. Modified Poisson regression models were used to evaluate the association between provider nonadherence and recurrence. The pre- (phase I) and post- (phase II) implementation groups included 91 patients (131 feet) and 68 patients (101 feet), respectively. The incidence of major recurrence (odds ratio: 59.5, 95% confidence interval: 7.8-454.4, The implementation of a clubfoot program was associated with a decrease in major clubfoot surgery and improved adherence to established guidelines for clubfoot management.
Identifiants
pubmed: 33575522
doi: 10.1097/pq9.0000000000000362
pmc: PMC7870159
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e362Informations de copyright
Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc.
Déclaration de conflit d'intérêts
The authors have no financial interest to declare in relation to the content of this article.
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