Multidisciplinary Cleft Palate Program at BC Children's Hospital: Are We Meeting the Standards of Care?

OBJECTIVE

To characterize current Cleft Palate Program (CPP) practices and evaluate the timeliness of appointments with respect to patient age and diagnosis based on American Cleft Palate-Craniofacial Association (ACPA) population guidelines and CPP patient-specific recommendations.

DESIGN

A retrospective review of CPP patient appointments from November 6, 2012, to March 31, 2015, was done. Data were analyzed using descriptive and inferential statistics.

SETTING

The study was conducted using data from the CPP at BC Children's Hospital.

PATIENTS

A total of 1214 appointments were considered in the analysis, including syndromic and nonsyndromic patients of 0 to 27 years of age.

MAIN OUTCOME MEASURES

Percentage of patients meeting follow-up targets by ACPA standards and CPP team recommendations.

RESULTS

Our results showed patients 5 years and younger or nonsyndromic were more likely to be seen on time ( < .001). No relationship between the timeliness of an appointment and specific patient diagnoses or distance to clinic was found. With the exception of nursing (97% of appointments were on time), all disciplines had less than 45% of appointments on time with 51% of appointments meeting ACPA guidelines for timeliness and 32% of all appointments meeting CPP recommendations.

CONCLUSION

Timely care for the cleft/craniofacial patient populations represents a challenge for the CPP. Although half of patients may meet the general ACPA guidelines, only 32% of patients are meeting the CPP patient-specific recommendations. To provide better patient care, future adjustments are needed, which may include improved resource allotment and program support.