Dr Rebecca Caesar1, Dr Francis Connon1, Dr Charles Kilburn1, Dr Lizelle Weber1
1Sunshine Coast University Hospital, Birtinya, Australia
Biography:
Dr Rebecca Caesar is the Clinical Lead of Paediatric Physiotherapy in the Women's and Children's Service, Sunshine Coast Hospital and Health Service. She has over two decades of experience in Paediatric Orthopaedics and currently co-ordinates the Physiotherapy team within a multidisciplinary service. She aims to foster a collaborative environment to deliver excellence in family centred care. Her research interests are focused on early detection and prioritised, cost-efficient service delivery.
Abstract:
Purpose:
The Sunshine Coast Hospital and Health Service District (SCHHS) has implemented a novel approach utilising an Advanced Physiotherapist working at full scope to promote early diagnosis and evidence-based management of developmental hip dysplasia (DDH).
Nature and Scope:
The model of care was developed in consultation between Orthopaedics, Neonatology and Allied Health and encompasses all aspects of DDH management in infants including universal screening at birth, selective hip ultrasound screening for high-risk infants and outpatient Orthopaedic care for infants with diagnosis of DDH.
Issue:
The SCCHS has a growing population with birth rates edging towards 4000 per annum. Without a Paediatric Orthopaedic subspecialty, the health service required an innovative solution to provide a sustainable DDH service. The solution includes a physiotherapy led DDH clinic supported by Orthopaedics. An Advanced Physiotherapist working at extended scope oversees intake and triage, orders hip USS co-signed by the consultant, orders XRs in accordance with the physiotherapist award and independently manages non-complex presentations from birth to 6 months corrected age. At 6 months of age, infants are discharged from the physiotherapy led clinic and continue ongoing hip surveillance with Orthopaedics. To ensure effective early detection the Advanced Physiotherapist provides ongoing training for medical staff and consults to the selective screening clinic providing recommendation for further surveillance or referral to the DDH clinic.
Outcome:
The model provides a cost-effective continuum of care from birth through diagnosis and intervention with robust detection and excellent clinical outcomes as evidenced by an almost zero rate to surgical conversion.