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Implementation of a novel vocal cord dysfunction management pathway using the consolidated framework for implementation research

Published online by Cambridge University Press:  05 August 2021

Greg Merlo
Affiliation:
Primary Care Clinical Unit, The University of Queensland, Brisbane, Australia
Jessica M Suna*
Affiliation:
Queensland Paediatric Cardiac Service, Queensland Children’s Hospital, Brisbane, Australia Child Health Research Centre, University of Queensland, Brisbane, Australia
Amy McIntosh
Affiliation:
Queensland Paediatric Cardiac Service, Queensland Children’s Hospital, Brisbane, Australia
Karen Jardine
Affiliation:
Speech Pathology Department, Queensland Children’s Hospital, Brisbane, Australia
Louise Kenny
Affiliation:
Queensland Paediatric Cardiac Service, Queensland Children’s Hospital, Brisbane, Australia School of Clinical Medicine, Children’s Health Queensland Clinical Unit, University of Queensland, Brisbane, Australia
Jennifer Orchard
Affiliation:
Queensland Paediatric Cardiac Service, Queensland Children’s Hospital, Brisbane, Australia
Mary Wilson
Affiliation:
Learning & Workforce Development, Queensland Children’s Hospital, Brisbane, Australia
Nelson Alphonso
Affiliation:
Queensland Paediatric Cardiac Service, Queensland Children’s Hospital, Brisbane, Australia Child Health Research Centre, University of Queensland, Brisbane, Australia
*
Author for correspondence: J. M. Suna, Queensland Paediatric Cardiac Service, Level 4, Centre for Children’s Health Research, PO Box 3474 Queensland Children’s Hospital, 501 Stanley Street, South Brisbane, QLD4101, Australia. Tel: +61 7 3069 7256; Fax: +61 7 3068 3169. E-mail: Jessica.Suna@health.qld.gov.au

Abstract

Every year in Australia over a thousand children who are born with congenital heart disease require surgical intervention. Vocal cord dysfunction (VCD) can be an unavoidable and potentially devastating complication of surgery for congenital heart disease. Structured, multidisciplinary care pathways help to guide clinical care and reduce mortality and morbidity. An implementation study was conducted to embed a novel, multidisciplinary management pathway into practice using the consolidated framework for implementation research (CFIR). The goal of the pathway was to prepare children with postoperative vocal cord dysfunction to safely commence and transition to oral feeding. Education sessions to support pathway rollout were completed with clinical stakeholders. Other implementation strategies used included adaptation of the pre-procedural pathway to obtain consent, improving the process of identifying patients on the VCD pathway, and nominating a small team who were responsible for the ongoing monitoring of patients following recruitment. Implementation success was evaluated according to compliance with pathway defined management. Our study found that while there were several barriers to pathway adoption, implementation of the pathway was feasible despite pathway adaptations that were required in response to COVID-19.

Type
Original Article
Copyright
© The Author(s), 2021. Published by Cambridge University Press

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References

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