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Updated: Jun 18, 2026
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Published on: August 8, 2019
Health professionals' experiences and barriers encountered when implementing hip surveillance for children with
Kate L Willoughby1,2, Rachel Toovey1, Jan M Hodgson3
1Centre of Research Excellence in Cerebral Palsy, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
Insights
Health professionals face barriers implementing hip surveillance for children with cerebral palsy (CP), including inconsistent radiology and communication challenges. Addressing these can improve care for young people with CP.
Area of Science:
- Pediatric Orthopedics
- Rehabilitation Medicine
- Public Health
Background:
- Hip surveillance is crucial for managing cerebral palsy (CP) in young people.
- Understanding health professionals' experiences is key to optimizing surveillance programs.
Purpose of the Study:
- To explore health professionals' experiences with hip surveillance for young people with CP.
- To identify barriers and facilitators in the implementation of hip surveillance programs.
Main Methods:
- A cross-sectional web-based survey was distributed to health professionals supporting children with CP.
- Mixed methods analysis was employed, utilizing descriptive statistics for scaled responses and qualitative thematic analysis for open-ended feedback.
Main Results:
- Key barriers included inconsistent radiology practices (35%), challenges in parent engagement (32%), and limited inter-clinician communication (31%).
- Qualitative analysis revealed themes around the importance of clinical guidelines, role clarity, shared responsibility, and effective communication.
Conclusions:
- Barriers exist throughout the hip surveillance process, but facilitators are also present.
- Findings can inform enhanced state-wide approaches to CP hip surveillance and are potentially transferable to other settings.
Aim:
This study aimed to explore health professionals' experiences of implementing hip surveillance for young people with cerebral palsy (CP) and to identify any barriers they encounter.
Methods:
A cross-sectional web-based survey of health professionals supporting children with CP was conducted. Responses were analysed through mixed methods. Responses to items presented as ordinal scales were analysed using descriptive statistics, and open-ended responses through a qualitative approach to identify themes.
Results:
A total of 32 paediatricians, 2 rehabilitation specialists and 50 physiotherapists completed the survey, with respondents working within both hospital- and community-based settings. Barriers most frequently reported were inconsistency in radiology practice and reporting (35%), parent engagement (32%), limited communication between clinicians (31%), lack of clarity in lines of responsibility (27%) and forgetting to undertake surveillance (26%). Four major themes were identified through qualitative analysis: (i) recognition of the importance of clinical guidelines to hip surveillance; (ii) the value of each role in the team around a child; (iii) the challenge of sharing responsibility; and (iv) the importance of communication in facilitating collaboration.
Conclusions:
Barriers can be encountered at each phase of the hip surveillance process, but there are also factors that act as facilitators. Locally, the results will inform the development of an enhanced state-wide approach to hip surveillance for all children with CP. The identified barriers do not appear unique to the local context, and the findings may be transferable to other settings. Awareness of the potential barriers and facilitators would be valuable to those implementing hip surveillance in other areas.
