Multidisciplinary Cleft Palate Program at BC Children’s Hospital: Are We Meeting the Standards of Care?

Dahiya, Anita; Courtemanche, Rebecca; Courtemanche, Douglas J.

doi:10.1177/2292550317747852

Cited by 6 publications

(9 citation statements)

References 11 publications

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“…16 Objective data from our previous study led to a quality improvement process for the CPP with the hospital administration, with the aim to improve clinical outcomes. 10 Our hypothesis that patients on the waitlist also have similar gaps in their care motivated us to objectively describe the care needs of this population. Understanding the care needs of patients, in this case, the CPP waitlist, is the first step to guide the system in supplying resources necessary to alleviate the impact of the additional wait times.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, the lack of speech language pathologists specialized in cleft care has meant that patients in BC have limited access to specialized speech services. 10 Some of these complex patients are considered vulnerable in the areas of family income, transportation, housing, education, literacy, legal issues, foster care, or safety. 11 The CPP sees patients from across BC and parts of the Yukon and Northwest Territories.…”

Section: Introductionmentioning

confidence: 99%

“…13 A previous study done at our institution in 2016 identified gaps in the delivery of care by the BCCH CPP. 10 The authors reviewed timeliness of 1214 BCCH CPP appointments over a 30-month period and compared patients' actual wait times to CPP team recommendations and ACPA guidelines. 10 The key results were that only 32% of the appointments met CPP patient-specific recommendations, and 52% of the appointments met ACPA recommendations.…”

Section: Introductionmentioning

confidence: 99%

“…10 The authors reviewed timeliness of 1214 BCCH CPP appointments over a 30-month period and compared patients' actual wait times to CPP team recommendations and ACPA guidelines. 10 The key results were that only 32% of the appointments met CPP patient-specific recommendations, and 52% of the appointments met ACPA recommendations. 10 This study stimulated an internal quality improvement process for the CPP with the hospital administration.…”

Section: Introductionmentioning

confidence: 99%

“…10 The key results were that only 32% of the appointments met CPP patient-specific recommendations, and 52% of the appointments met ACPA recommendations. 10 This study stimulated an internal quality improvement process for the CPP with the hospital administration. However, one of the study limitations was that patients on the waitlist who were yet to be seen by the CPP were not included in the analysis.…”

Section: Introductionmentioning

confidence: 99%

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A Cross-Sectional Analysis of the BC Children’s Hospital Cleft Palate Program Waitlist

et al. 2019

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Objective: A 2016 review of the BC Children’s Hospital Cleft Palate - Craniofacial Program (CPP) revealed that one-third of patients met the program’s care recommendations and half met the American Cleft Palate-Craniofacial Association guidelines. This study reviews patients on the CPP waitlist and determines median wait times and missed clinical assessments as well as identifies how wait times are influenced by medical complexity, specialized speech service needs, vulnerability, and distance from clinic. Design: Cross-sectional. Setting: BC Children’s Hospital Cleft Palate—Craniofacial Program. Patients: Five hundred seventy-six waitlisted patients. Main Outcome Measures: Additional wait time after recommended appointment date. Correlation of additional wait time with diagnosis, number of specialists required, speech services needed, vulnerability, and distance from the clinic. Missed plastic surgery, speech, and orthodontic assessments according to CPP team recommendations and ACPA guidelines. Results: Patients had a median additional wait time of 11 months (interquartile range: 5-27). Longer additional wait times were associated with a craniofacial diagnosis ( P = .019), a need for formal speech assessments or evaluations ( P < .001), or a requirement to see multiple specialists ( P < .001). Vulnerability and distance from clinic did not affect wait times. Plastic surgery assessments were not available at the preschool and preteen time points for 45 (8%) patients, 355 (62%) patients were unable to access speech assessments, and 120 (21%) were unable to complete an orthodontic assessment. Conclusion: Patients wait up to an additional year to be seen by the CPP and miss speech, orthodontic, and surgical assessments at key developmental milestones. Additional resources are required to address these concerns.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Cross-Sectional Analysis of the BC Children’s Hospital Cleft Palate Program Waitlist

et al. 2019

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Leveraging Data Collection and Analysis to Optimize Outcomes in Surgical Cleft Care: Deciphering the Quality Improvement Puzzle

Denadai¹,

2022

Current Concept in Cleft Surgery

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Experiences of Canadian Parents of Young Children With Cleft Lip and/or Palate

Breuning

Courtemanche

2020

The Cleft Palate-Craniofacial Journal

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Purpose: Prior literature has described the perspectives of parents of young children with clip lip and/or palate; however, few studies have described parents’ experiences within a Canadian health care system. This study aims to better understand the experiences of parents of young children with cleft lip and/or palate seen at a Canadian tertiary care center and identify their care needs. Design: In-depth semistructured interviews. Setting: Pediatric tertiary care center. Participants: Parents of children younger than 7 years of age with cleft lip and/or palate. Results: From 14 interviews, 4 themes were identified. The diagnosis theme was associated with reactions, timing, and search for information. Key concerns within the theme of physiology and function were around feeding and speech. The health care experience theme included burden of care, peripheral hospitals and services, the cleft lip and palate clinic, and clinicians. The psychosocial theme included parents’ reactions to their child’s pain, coping strategies, family interactions, and school/day care experiences. Parents felt care could be improved by having: access to good information and community speech therapists, shorter appointment wait times, a peer support network, and increased cleft knowledge within their child’s school and peer groups. Conclusions: The experience of parents of children with cleft lip and/or palate is complex but can be organized into 4 themes. Clinics may consider suggestions offered by parents to improve care. Future work should address parents’ needs and aim to create a parent-reported quality-of-life measure specific to parents of young children with cleft lip and/or palate.

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Multidisciplinary Cleft Palate Program at BC Children’s Hospital: Are We Meeting the Standards of Care?

Cited by 6 publications

References 11 publications

A Cross-Sectional Analysis of the BC Children’s Hospital Cleft Palate Program Waitlist

A Cross-Sectional Analysis of the BC Children’s Hospital Cleft Palate Program Waitlist

Leveraging Data Collection and Analysis to Optimize Outcomes in Surgical Cleft Care: Deciphering the Quality Improvement Puzzle

Experiences of Canadian Parents of Young Children With Cleft Lip and/or Palate

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