Bamigbade Sandra-Eve, Sopena Sara, Hedderly Tammy, Malik Osman, Owen Tamsin, Ludlow Amanda K
University of Hertfordshire Department of Psychology Sport and Geography, Hatfield, UK
University of Hertfordshire Centre for Research in Public Health and Community Care, Hatfield, UK.
BMJ Open Qual. 2025 Jul 17;14(3):e002919. doi: 10.1136/bmjoq-2024-002919.
Sensory, eating and mealtime (SEM) challenges are common among young people with neurodevelopmental movement disorders but are rarely assessed during initial clinical consultations. This quality improvement project aimed to evaluate the impact of routine SEM screening on identifying these challenges and improving documentation and follow-up in a specialist paediatric movement disorder clinic in England. Using the SHIFT-Evidence Framework and a Plan-Do-Study-Act approach, the project implemented and evaluated a series of interventions. In the phase, clinicians participated in a workshop to raise awareness of SEM challenges and inform the development of screening questions to support routine SEM assessment. The phase involved implementing routine SEM screening during a 3 month trial, supported by active measures such as project champions, weekly reminders and team discussions to encourage sustained practice. The phase included analysis of assessment outcome letters from three time points (baseline, trial and outcome retention phases) to evaluate changes in documentation and the sustainability of improvements. In the phase, findings were shared with the team, resulting in improved signposting, targeted recommendations and ongoing collaborations with feeding clinics. Findings demonstrated increased documentation of SEM challenges in assessment letters, with mentions rising from 33% at baseline to 71.9% during the trial and 64.3% in the retention phase. However, actionable recommendations and interventions remained limited during the trial but showed improvement in the retention phase, where letters included more tailored guidance and specific advice for SEM challenges. This project highlights the prevalence of SEM challenges among young people with neurodevelopmental movement disorders and underscores the importance of routine SEM screening. Developing standardised assessment tools and protocols could further aid clinicians in identifying and addressing these challenges during initial assessments.
感觉、进食和用餐时间（SEM）方面的挑战在患有神经发育性运动障碍的年轻人中很常见，但在初次临床会诊时很少进行评估。这个质量改进项目旨在评估常规SEM筛查对识别这些挑战以及改善英国一家专科儿科运动障碍诊所的记录和后续跟进的影响。该项目采用SHIFT-证据框架和计划-执行-研究-行动方法，实施并评估了一系列干预措施。在第一阶段，临床医生参加了一个研讨会，以提高对SEM挑战的认识，并为支持常规SEM评估的筛查问题的制定提供信息。第二阶段包括在为期3个月的试验期间实施常规SEM筛查，并通过项目负责人、每周提醒和团队讨论等积极措施来鼓励持续实践。第三阶段包括分析来自三个时间点（基线、试验和结果保留阶段）的评估结果信函，以评估记录的变化和改进的可持续性。在第四阶段，研究结果与团队分享，从而改进了指引、针对性建议以及与喂养诊所的持续合作。研究结果表明，评估信函中关于SEM挑战的记录有所增加，提及率从基线时的33%上升到试验期间的71.9%，在保留阶段为64.3%。然而，在试验期间，可采取行动的建议和干预措施仍然有限，但在保留阶段有所改善，此时信函中包含了更多针对SEM挑战的量身定制的指导和具体建议。这个项目突出了患有神经发育性运动障碍的年轻人中SEM挑战的普遍性，并强调了常规SEM筛查的重要性。开发标准化的评估工具和方案可以进一步帮助临床医生在初次评估时识别和应对这些挑战。
