Peter G Bittar1, Anna R Carlson2, Ann Mabie-DeRuyter3,4, Jeffrey R Marcus2,4, Alexander C Allori2,4. 1. 1 Duke University School of Medicine, Durham, NC, USA. 2. 2 Division of Plastic, Maxillofacial and Oral Surgery, Department of Surgery, Duke University Hospital, Durham, NC, USA. 3. 3 Division of Otolaryngology and Communication Sciences, Department of Surgery, Duke University Hospital; Durham, NC, USA. 4. 4 Duke Cleft and Craniofacial Center, Duke Children's Hospital, Durham, NC, USA.
Abstract
OBJECTIVE: Our objective is to describe the process of adapting a conceptual framework into a practical toolkit for one cleft team. DESIGN: This is a single-arm implementation study in a single institution. SETTING: Implementation took place at a mid-sized multidisciplinary clinic for patients with cleft lip and/or palate (CL/P) from urban/suburban and rural areas across North Carolina and neighboring states. PARTICIPANTS: Eligible participants were patients with CL/P from English-speaking families. Sixty patients entered and finished the study. INTERVENTIONS: The implementation of a prospective data collection system based on the International Consortium for Health Outcomes Measurement (ICHOM) standard set of outcome measures for CL/P was accomplished in multiple stages. Patient- and clinician-reported forms and protocols for gathering data were created. Team members were trained and the system was tested; finally, the system was deployed. MAIN OUTCOME MEASURES: Success was appraised using the RE-AIM framework to assess reach, effectiveness, adoption, implementation, and maintenance. RESULTS: Ninety-eight percent of patients and all team members agreed to participate. Ninety-four percent of required data were captured. Adaptations to friction points were made; specifically, visible reminders were affixed to charts, primary clinicians were required to assume data entry responsibility, and e-mail reminders were instituted. Development cost was US$7707; average time cost per clinician was 21 min/wk. CONCLUSIONS: Conceptual frameworks for outcomes studies must be tailored to their environments; otherwise, they cannot be practically implemented and sustained. We present this process for a cleft team using the ICHOM standard set. The process may help other teams implement the standard set or other conceptual frameworks.
OBJECTIVE: Our objective is to describe the process of adapting a conceptual framework into a practical toolkit for one cleft team. DESIGN: This is a single-arm implementation study in a single institution. SETTING: Implementation took place at a mid-sized multidisciplinary clinic for patients with cleft lip and/or palate (CL/P) from urban/suburban and rural areas across North Carolina and neighboring states. PARTICIPANTS: Eligible participants were patients with CL/P from English-speaking families. Sixty patients entered and finished the study. INTERVENTIONS: The implementation of a prospective data collection system based on the International Consortium for Health Outcomes Measurement (ICHOM) standard set of outcome measures for CL/P was accomplished in multiple stages. Patient- and clinician-reported forms and protocols for gathering data were created. Team members were trained and the system was tested; finally, the system was deployed. MAIN OUTCOME MEASURES: Success was appraised using the RE-AIM framework to assess reach, effectiveness, adoption, implementation, and maintenance. RESULTS: Ninety-eight percent of patients and all team members agreed to participate. Ninety-four percent of required data were captured. Adaptations to friction points were made; specifically, visible reminders were affixed to charts, primary clinicians were required to assume data entry responsibility, and e-mail reminders were instituted. Development cost was US$7707; average time cost per clinician was 21 min/wk. CONCLUSIONS: Conceptual frameworks for outcomes studies must be tailored to their environments; otherwise, they cannot be practically implemented and sustained. We present this process for a cleft team using the ICHOM standard set. The process may help other teams implement the standard set or other conceptual frameworks.
Authors: Rose T Tillis; Reanna Shah; Hannah L Martin; Alexander C Allori; Jeffrey R Marcus; Dennis O Frank-Ito Journal: Int J Comput Assist Radiol Surg Date: 2021-06-02 Impact factor: 2.924
Authors: Inge Apon; Carolyn R Rogers-Vizena; Maarten J Koudstaal; Alexander C Allori; Petra Peterson; Sarah L Versnel; Jessily P Ramirez Journal: Cleft Palate Craniofac J Date: 2021-03-05