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- Talk
- 15/09/2021
- Canada
The Pediatric Orthopaedic Surgery Burden: Can Modification of Referral Criteria Help Alleviate Departmental Strain?
Description
In this presentation, Alicia Kerrigan discusses the burden of pediatric orthopedic surgery (POS) and explores whether modifying referral criteria can alleviate strain on these departments. She begins by acknowledging co-contributors and highlighting that 20% to 30% of pediatric complaints pertain to musculoskeletal issues, many of which can be handled by primary care physicians. Kerrigan notes that studies have shown inappropriate referral rates can reach as high as 53%, including normal conditions that don't require specialist attention.
In response, the American Academy of Pediatrics (AAP) created referral guidelines aimed at improving the efficiency of these referrals. The study aims to apply these guidelines to the POS referral population at CHEO, and to propose modifications suited to the Canadian healthcare context. A retrospective chart review of six months of new referrals was carried out to classify them as appropriate or inappropriate based on standard criteria.
Results showed that out of 1,355 referrals analyzed, 55% were deemed inappropriate, with a significant portion classified for conditions like simple musculoskeletal pain or normal physiologic variance. By implementing additional specific age-related criteria, appropriate referrals necessitating surgical intervention increased from 98.2% to 99.4%. However, the results also uncovered issues regarding the quality of certain referrals, many of which lacked critical information such as clinical history and focused questions.
Kerrigan emphasizes the need for improved medical education, particularly in musculoskeletal topics, to reduce inappropriate referrals. The study concludes that streamlining referral processes could significantly reduce wait times and enhance patient care efficiency. Future recommendations include establishing standardized referral forms and targeted training for medical professionals.