RightPath: a model of community-based musculoskeletal care for children

Area of Science:

• Pediatric healthcare
• Musculoskeletal conditions
• Healthcare delivery models

Background:

• Musculoskeletal (MSK) conditions are common in children, frequently leading to healthcare consultations.
• Many pediatric MSK issues are self-limiting or represent normal developmental variations.
• Current systems often lead to hospital referrals for conditions manageable in primary care.

Purpose of the Study:

• To develop and evaluate a novel care model for pediatric MSK presentations.
• To identify children suitable for management by community-based pediatric physiotherapists and/or podiatrists.
• To reduce unnecessary referrals to specialist hospital services.

Main Methods:

• A mixed-methods approach was used to assess feasibility, acceptability, and transferability across two UK sites.
• Evaluation involved analyzing patient flow, referral times, diagnostic outcomes, and user feedback via questionnaires, focus groups, and interviews.
• General practitioner referrals for pediatric MSK issues (<16 years) were triaged by nurses or allied health professionals using a standardized guide.

Main Results:

• Approximately 25% of all MSK referrals were successfully triaged for community management by pediatric physiotherapists/podiatrists.
• A significant majority (67%) of these cases were diagnosed as normal variants.
• Families reported high satisfaction, with no adverse events or re-presentations for serious MSK pathology within six months post-triage.

Conclusions:

• The developed triage model is feasible, acceptable, and transferable for managing pediatric MSK complaints in the community.
• This multi-professional approach enhances collaboration between primary, community, and specialist care providers.
• The model facilitates appropriate and timely care, improving patient outcomes and optimizing resource utilization.