ABSTRACT
INTRODUCTION: Care Coordination is the health care delivery model that has been implemented in the prosthetic clinic at the Shriners Hospital for Children - Canada. In delivering comprehensive, family-centered services, it is important to evaluate the extent to which patients and families perceive coordinated care to occur. AIM: To evaluate the delivery of Care Coordination services to our patients and families in the prosthetic clinic, and to identify strengths and areas for improvement. The time required to provide coordinated care was also evaluated. METHODS: The MPOC-20 was administered to the parents of 23 lower extremity deficiency or amputee patients seen in the prosthetic clinic over a 14-month period. RESULTS: Providing coordinated and comprehensive care related to involving families as part of the team was the most frequently reported strength of the prosthetic clinic Care Coordination. Providing information to families about their child's progress and having information and resources available were areas identified as needing improvement by approximately 30% of respondents. Those with complex health needs required five times the amount of Care Coordination devoted time than the average patient. CONCLUSIONS: The MPOC-20 proved to be a useful tool to highlight areas for improvement in the prosthetic clinic and to validate aspects of care coordination that were appreciated by families.
ABSTRACT
PURPOSE: This article reports on the process used to appraise evidence-based physiotherapy practice when treating nonspecific low back pain (LBP) in children and adolescents. METHOD: Best clinical practices were identified using 9 systematic reviews reporting on effectiveness of physiotherapy for individuals with nonspecific LBP. Fifty medical charts were reviewed to appraise practice. RESULTS: All literature reviews reported solely on adult treatment, none included children or adolescents. Strong evidence supported the effectiveness of therapeutic exercises and education. There was insufficient evidence to support the effectiveness of thermotherapy, transcutaneous electrical nerve stimulation, or ultrasound. Chart reviews indicated therapeutic exercises were prescribed for all 50 pediatric patients and postural education was provided to 48 patients. Eleven patients received thermotherapy, three received transcutaneous electrical nerve stimulation, and none was treated with ultrasound. CONCLUSIONS: Published literature reviews enabled physiotherapists to appraise evidence-based practices. Clinical guidelines for treating nonspecific LBP in children and adolescents are needed.
