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Achieving and Sustaining Standardized Measurement of Treatment Outcomes in Children With Cleft Lip/Palate: Pilot
Thomas J Sitzman1,2,3, Jessica L Chee-Williams1,4, Davinder J Singh1,2,3
1Phoenix Children's Center for Cleft and Craniofacial Care, Division of Plastic Surgery, Phoenix Children's Hospital, Phoenix, AZ, USA.
Insights
A new strategy significantly improved standardized outcome collection for children with cleft lip and/or palate (CL/P). This approach enhanced aesthetic, dental, and speech outcome measurements, showing high provider acceptance.
Area of Science:
- Cleft lip and palate research
- Healthcare implementation science
- Pediatric health outcomes
Background:
- Standardized outcome measurement in cleft care faces numerous barriers.
- Effective strategies are needed to improve data collection for children with cleft lip and/or palate (CL/P).
Purpose of the Study:
- To evaluate a multifaceted implementation strategy for collecting standardized outcomes in CL/P care.
- To assess the impact of this strategy on the penetration and acceptability of outcome measurements.
Main Methods:
- A one-armed, single-site pilot study was conducted with five-year-old children with CL/P.
- A multifaceted implementation strategy was employed to collect standardized aesthetic, dental, and speech outcomes.
- Penetration rates pre- and post-implementation were compared, alongside provider and staff acceptability using the Acceptability of Intervention Measure.
Main Results:
- The strategy significantly increased the measurement of aesthetic outcomes (7% to 82%), dental outcomes (0% to 56%), and speech outcomes (29% to 77%).
- Acceptability was high, with 93% of cleft team providers and staff approving of the standardized measurement.
- High rates of outcome measure collection were sustained for four years post-implementation.
Conclusions:
- A multifaceted implementation strategy effectively increased the collection of standardized aesthetic, dental, and speech outcomes for children with CL/P.
- The strategy demonstrated high acceptability among healthcare providers and staff.
- Sustained high rates of data collection indicate the long-term viability of the implementation approach.
Abstract:
ObjectivePrior work has identified numerous barriers to standardized outcome measurement in cleft care. The objective of this study was to evaluate a multifaceted implementation strategy to collect standardized outcomes for children with cleft lip and/or palate (CL/P).DesignA one-armed, single-site pilot study of a multifaceted implementation strategy.SettingA metropolitan children's hospital.PatientsFive-year-old children with CL/P.InterventionsA multifaceted implementation strategy for standardized outcome measurement.Main Outcomes MeasuresThe primary outcome measure was penetration of the intervention, defined as the proportion of children for whom the standardized measures of aesthetic, dental, and speech outcomes were collected. Penetration pre-implementation and 12 months post-implementation were compared. The secondary outcome was acceptability of standardized outcome measurement among providers and staff, evaluated with the Acceptability of Intervention Measure.ResultsThe implementation strategy resulted in high penetration of standardized outcome measurement: measurement of aesthetic outcomes increased from 7% to 82% (p < .0001); measurement of dental outcomes increased from 0% to 56% (p < .0001); measurement of speech outcomes increased from 29% to 77% (p = .0001). Acceptability of standardized outcome measurement was high, with 93% of cleft team providers and staff (n = 14/15) reporting that they somewhat or completely agreed that standardized outcome measurement met their approval, was appealing, was welcomed, and was liked. Penetration continued to improve after the implementation period, with high rates of outcome measure collection sustained for four years following implementation.ConclusionsDeployment of a multifaceted implementation strategy led to substantial increases in the collection of aesthetic, dental, and speech outcomes among children with CL/P.
