A HYBRID VIRTUAL BABY HIP CLINIC IMPROVES CARE FOR THE NONOPERATIVE TREATMENT OF DEVELOPMENTAL DYSPLASIA OF THE HIP IN INFANTS
Notice bibliographique
Résumé
Recent literature has demonstrated that standardized protocols and more limited use of ultrasound can be safely implemented with excellent outcomes in the nonoperative management of developmental dysplasia of the hip (DDH) in infants. Implementation of remote care management across healthcare services is increasingly affording reduced travel and costs to caregivers, with high rates of satisfaction. There was consensus among our clinician team that hybrid in-person and virtual care in clinic would provide numerous improvements in family-centred care. Therefore, we established a new hybrid virtual model of care in our Baby Hip Clinic for DDH. This quality improvement study implemented a Plan-Do-Study-Act iterative model. This study occurred in a unified multidisciplinary Baby Hip Clinic between December 2022 and October 2023. Practice changes were made to a published comprehensive nonoperative DDH treatment protocol by switching to virtual interim follow-up visits for consultation and examination, and omitting ultrasound examination once the hip was centred as per evidence-based guidelines. New online educational resources for caregivers were added to supplement reduced in-person care. A dedicated clinic email was created for streamlined asynchronous clinical advice from healthcare providers. Caregiver and staff satisfaction surveys were administered to collect feedback on satisfaction, clinic flow and perceived quality of care. Fifty-two infants and their caregivers, and 20 staff were enrolled in the study. Forty-nine infants successfully completed the brace treatment. Three infants failed brace treatment, and two developed femoral nerve palsy, which resolved, and both successfully completed brace treatment. No failures of brace treatment or complications occurred during the virtual follow-up care period. Seventy-seven virtual follow-up visits occurred in place of in-person visits. Travel to the clinic was reduced by 6,220 km for caregivers. Seventy-seven fewer ultrasound scans were ordered, saving $15,500 in imaging costs, compared to previous standardized protocol. The institutional DDH educational website drew over 12,000 views during the 11-month study period, and the new Baby Hip Clinic email received over 38 emails requesting advice on DDH and brace care. 265 caregiver satisfaction surveys and 45 staff satisfaction surveys were completed. 93% of caregivers were either satisfied or very satisfied with virtual visits, and 85.1% of staff rated satisfaction with virtual appointments as either good or excellent. This study successfully streamlined care to minimize in-person visits, made use of the hospital's new virtual care platforms, reduced the need for expensive, scarce imaging resources, and improved caregiver experience while maintaining exceptional clinical results. Our hybrid virtual Baby Hip Clinic represents an advance in the model of care for nonoperative management for DDH which could increase equitable access, especially for those in remote and economically challenged areas.
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».