Journal of Pediatric Rehabilitation Medicine - Volume 14, issue 4

Authors: McLaughlin, Matthew J. | Modrcin, Ann C. | Hickman, Timothy P. | Hoffman, Mark

Article Type: Research Article

Abstract: PURPOSE: The objective of this study was to analyze the effects on patient access by decreasing missed appointments after hiring a clinic coordinator using medical informatics. METHODS: A single-center retrospective analysis of the rates of missed appointments before and after hiring a clinic coordinator in a multidisciplinary spinal differences clinic were analyzed using a commercially available business software system (SAP® Business Objects). The total number of clinic visits was collected for each month to determine the access available for patients. RESULTS: The median number of missed appointments per clinic by month before employing the clinic coordinator …was higher than in the two years following implementation (p  < 0.0005). No differences were seen in the number of available appointment slots per month indicating no new clinics were needed to improve patient access (p  = 0.551). Projected billing amounts prior to hiring the clinic coordinator indicated that $91,520 was lost in the 2 years prior to hiring this coordinator compared to $30,160 lost during the 2 years following the creation of this position (p  = 0.0009). CONCLUSION: Hiring a clinic coordinator decreased the rate of missed appointments and was a cost-efficient intervention to improve patient access and provide effective patient care in a multidisciplinary setting. Show more

Keywords: Pediatrics, spinal dysraphism, appointments and schedules, no-show patients, spina bifida, coordination (administrative), patient appointments, informatics

DOI: 10.3233/PRM-200790

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 14, no. 4, pp. 661-666, 2021

Authors: Hopson, Betsy | Shamblin, Isaac | Zimmerman, Kathrin | Rocque, Brandon | Salehani, Arsalaan | Blount, Jeffrey P.

Article Type: Research Article

Abstract: PURPOSE: Children with myelomeningocele are known to be consumers of substantial healthcare resources, with many early hospital encounters. The purpose of this study was to survey the extent of medical and surgical care that patients with myelomeningocele receive during the first four years of life. METHODS: Clinical and demographic data were collected on newborn infants with open myelomeningocele from the Children’s of Alabama Spina Bifida Web Tracker, a prospective, comprehensive spina bifida database. Additional data pertaining to all hospital admissions, surgical procedures, and clinic visits were collected from the medical record. RESULTS: One …hundred and fourteen subjects with a primary diagnosis of myelomeningocele between 2004 and 2015 were included. Males slightly predominated (55%), 61.4% were Caucasian, 11% Hispanic/Latino; 28% had a mid-lumbar functional lesion level. Over the first four years of life, 688 total surgical procedures were performed (an average of 86 per child): 438 in year 1, 100 in year 2, 84 in year 3, and 66 in year 4. The mean number of hospital visits was 40.5. Total average drive time per patient over 4 years being 103.8 hours. Average number of nights spent in the hospital was 51. CONCLUSION: Children with myelomeningocele need multiple hospitalizations, surgeries, and medical encounters in the first 4 years of life. These data will be valuable when counselling new parents and prospective parents of children with this condition. Show more

Keywords: Spina bifida, myelomeningocele, pediatrics, scope of care

DOI: 10.3233/PRM-200803

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 14, no. 4, pp. 667-673, 2021

Authors: Kelly, Maryellen S. | Stout, Jennifer | Wiener, John S.

Article Type: Research Article

Abstract: PURPOSE: Neurogenic bowel dysfunction (NBD) affects 80% of individuals with spina bifida. Performing and disseminating research on NBD to reach the appropriate audience is difficult given the variability among medical specialties managing NBD. This study aimed to identify which medical specialties and types of providers are currently managing NBD in the United States. METHODS: A survey was developed and sent to 75 spina bifida clinics. Surveys queried which specialty was primarily responsible for medical and surgical management of NBD and any others that assist in NBD care. The license and certification level of the providers were collected. Descriptive …statistics were performed to describe the results. RESULTS: Response rate was 68%. Urology was the leading specialty primarily responsible for NBD management (39%) followed by rehabilitation medicine and developmental pediatrics (22% and 20%, respectively). Physicians were the primary providers of care followed by nurse practitioners (54% vs 31%). Urology performs 65% of NBD surgeries. CONCLUSION: Multiple specialties and providers are involved in NBD management with variation among clinics. Development of improved NBD care should include a spectrum of specialties and providers. Dissemination of research should be aimed at multiple specialty groups. Show more

Keywords: Spina bifida, neurogenic bowel, fecal incontinence

DOI: 10.3233/PRM-201512

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 14, no. 4, pp. 675-679, 2021

Authors: Garver, Amanda E. | Mohanty, Salini | Dicianno, Brad E. | Turchi, Renee M.

Article Type: Research Article

Abstract: PURPOSE: The objective of this study was to describe the knowledge, attitudes, and practices related to caring for youth with SB within a statewide pediatric primary care medical home network. METHODS: Health care professionals who were members of the Pennsylvania Medical Home Program (PAMHP) statewide network were surveyed on sociological demographics, confidence in and knowledge of topics that impact the spina bifida (SB) population, education on SB, designating responsibility of care, tasks completed in the office, and transition from pediatric to adult care from October 2016 through November 2016. RESULTS: Among 67 respondents, 78%believed counseling families/caregivers …about the impact of SB on everyday life was a shared responsibility between primary care physicians (PCP) and SB clinics. Eighty five percent of participants indicated they had exposure to SB through clinical courses or didactics in training but only 54%of participants felt knowledgeable on the impact of SB on everyday life. CONCLUSION: Findings suggest a need for increased educational efforts, improved awareness of SB, and access to evidence-based guidelines for PCPs to promote accessible and coordinated care to individuals with SB. Show more

Keywords: Patient-centered care, spina bifida, spinal dysraphism, transitional care

DOI: 10.3233/PRM-210039

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 14, no. 4, pp. 681-689, 2021

Authors: Castillo, Jonathan | Fremion, Ellen | Morrison-Jacobus, Melissa | Bolin, Rhonda | Perez, Ana | Acosta, Eva | Timmons, Kelly | Castillo, Heidi

Article Type: Brief Report

Abstract: The COVID-19 pandemic has posed distinctive challenges to adolescents and young adults living with spina bifida, especially those from ethic minority populations. With this public health challenge in mind, developing a customized electronic health record to leverage registry data to promote and quantify COVID-19 vaccination uptake among this population is feasible. We provide a brief description of our activities in customizing an electronic health record to track vaccination uptake among adolescents and young adults with spina bifida (AYASB); and the lessons learned, in hopeful support of those scaling-up vaccination delivery across the globe for AYASB as they transition to adult-centered …care. Thus, as providers think globally and act locally, COVID-19 immunization efforts can be implemented while providing culturally appropriate transition policies and services for individuals with neurodevelopmental disabilities. Show more

Keywords: Transition to adult-centered care, spina bifida, care coordination, COVID-19, mental health, health disparities, blue-marble health, SARS-CoV-2 vaccine, quality improvement

DOI: 10.3233/PRM-210119

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 14, no. 4, pp. 691-697, 2021

Article Type: Other

DOI: 10.3233/PRM-219014

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 14, no. 4, pp. 699-699, 2021

Article Type: Other

DOI: 10.3233/PRM-219013

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 14, no. 4, pp. 701-704, 2021