When it comes to treating kids with cerebral palsy (CP), there’s an international consensus growing – spurred by publications in Australia and Scandinavia – that kids with CP have higher risk of hip subluxation and dislocation.
Holland Bloorview practitioners immediately understood the implications. “Hip subluxation affects quality of life by causing pain, disturbance in gait and seating difficulties,” explained Chun Kim, Holland Bloorview physiotherapist. “It also presents caregiving challenges and increased health care costs.”
Holland Bloorview is committed to innovative research and treatment practices for improving care for kids with disabilities. Our hospital is also a Knowledge Translation (KT) leader. Under the leadership of our Evidence to Care (EtC) team, we connect our two worlds – research and care – by turning Bloorview Research Institute’s findings into innovative care practices.
Knowledge Translation Comes to Life with Hip Surveillance Care Pathway
Holland Bloorview’s approach to treating kids with CP is a great example of how KT comes to life in our hospital.
After examining the challenges of hip subluxation, an interdisciplinary team – including staff from our medical, nursing, physiotherapy, and Evidence to Care teams – developed the Hip Surveillance Care Pathway, an evidence-informed tool that gives guidelines and best practices to help all practitioners treating kids with CP at Holland Bloorview.
The Care Pathway was recognized by Evidence to Care as Holland Bloorview’s third annual Knowledge Translation Champion.Team members were Dr. Anne Kawamura, Dr. Angie Ip, Chun Kim PT, Peggy Curtis RN, Dr. Shauna Kingsnorth and Dr. Darcy Fehlings.
Tailored for Holland Bloorview’s Needs
Similar tools have been developed in other countries, but our Pathway was made specific to Holland Bloorview’s programs and clients’ needs. “We reviewed the evidence and determined what works best for Holland Bloorview kids,” said Dr. Anne Kawamura, Developmental Paediatrician. “The Pathway reflects how services are delivered here,” added Chun Kim.
Making a Difference
The Pathway has been in use for over a year and it is already making a difference. The team has interviewed practitioners and conducted chart audits to help determine the Pathway’s impact and whether any modifications were needed. They found that, prior to the Care Pathway in place, only 33 percent of Holland Bloorview clinicians followed an evidence-informed guideline. Today, that number is 100 percent.
Similarly, before implementation, 86 percent of children with CP seen at Holland Bloorview had hip surveillance consistent with a care pathway. Today that number is 95 percent.
The KT benefits are also significant. “The program gets everyone on the same page for terminology and protocol,” explained Chun Kim.
A Springboard for the Future
The journey continues.
Within Holland Bloorview, KT will continue growing with more information-sharing on clinical assessment and reading x-rays. It also extends outside Holland Bloorview as our staff have been sharing our best practices throughout the province. The team presented at the Ontario Association of Children’s Rehab Services (OACRS) Annual Conference, and helped launch the Ontario Hip Surveillance Working Group. “We believe it’s important to get all of Ontario onboard,” said Dr. Kawamura.
Focusing on Wellness
It’s all part of a focus on wellness. As Dr. Kawamura emphasizes: “Our vision is that we will talk about each kid’s overall wellness, rather than CP as a disease.”
This perspective is transforming the way we deliver care – keeping the kids’ overall wellness top of mind from birth until adulthood.
For more information, visit Holland Bloorview's Hip Surveillance Pathway page.