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Assessment of Head Shape by Craniofacial Teams: Structuring Practice Parameters to Optimize Efficiency.

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High-volume practices increasingly use dedicated clinics, laser scanners, and licensed independent providers for head shape abnormalities. This shift aids in managing the rise in positional plagiocephaly referrals.

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Area of Science:

  • Craniofacial Surgery
  • Pediatric Plastic Surgery
  • Medical Device Technology

Background:

  • Referrals for positional plagiocephaly have surged 600% since 1992.
  • Increased patient volume complicates differentiating positional head shape issues from craniosynostosis.
  • Positional plagiocephaly often requires conservative management like helmets or positioning, but accurate diagnosis is crucial.

Purpose of the Study:

  • To investigate how medical practices manage the growing number of head shape abnormality patients.
  • To identify differences in management strategies between low, medium, and high-volume practices.
  • To understand the adoption of specific diagnostic tools and staffing models in response to increased patient load.

Main Methods:

  • An electronic survey was distributed to members of the American Society of Maxillofacial Surgeons and the American Cleft Palate Association (ACPA).
  • Practices were stratified into low (<4/month), medium (5-20/month), and high (>21/month) patient volume categories.
  • Pearson's chi-squared test was employed to analyze significant differences in practice characteristics based on volume.

Main Results:

  • High-volume centers (80%) are significantly more likely to have dedicated head shape clinics (P < 0.0005).
  • Stationary laser scanners are utilized by 33.3% of high-volume practices (P = 0.023).
  • Licensed independent providers (LIPs) are involved in initial evaluations in 53.3% of high-volume settings (P = 0.032).

Conclusions:

  • High-volume practices demonstrate distinct management approaches for head shape abnormalities.
  • These practices are more inclined to adopt advanced technologies like stationary laser scanners.
  • The integration of LIPs and dedicated clinics signifies a strategic adaptation to increased patient caseloads.