Implementing Best Practice to Identify Cerebral Palsy in Infants
There is strong evidence that a novel video-based technique, the General Movements (GMs) assessment, is an accurate and effective tool for the early identification of infants at risk of CP. Despite this, GMs was not routinely used by the Childrens Hospital Westmead to assess its infant surgical population – a cohort with known risk factors for CP.
To address this evidence-practice gap, clinician-researchers at the hospital’s Grace Centre for Newborn Intensive Care undertook a multi-faceted knowledge translation intervention study, which addressed staff-identified barriers to implementation of GMs.
The study employed several implementation strategies including peer-to-peer support to overcome knowledge and skill barriers, change in workflow practices and reminders at the point of decision-making to overcome time barriers, and training opinion leaders and role models to shift attitudinal barriers.
“We know that training is not enough, so we used trained opinion leaders,” said Chief Investigator Dr Cathryn Crowle. “We were very fortunate in that our medical team was completely on board and so understood the importance. So, when we did the training it was senior medical staff, occupational therapy, physiotherapy, all trained at the same time, which then was a very important thing when it came to implementation.”
Grace Centre Medical Director, Professor Nadia Badawi, said the keys to successful implementation were collaboration and leadership.
“Change does not come because one or two people thought they could do it on their own,” she said. “It really was a collaboration between researchers, parents, philanthropists, public policy. It’s everyone getting together and wanting to do it – and having some very powerful and influential voices.”