title: Compliance to service standards for congenital upper limb deficiency: the Northern Ireland experience.
abstract: BACKGROUND
  In 2003, the British Society of Rehabilitation Medicine (BSRM) published guidelines on amputee and prosthetic rehabilitation, including those with congenital limb deficiency.
  
  
  OBJECTIVE
  The aim of the study was to evaluate the service provided by the Regional Disablement Service (RDS) to children with congenital upper limb deficiency, against BSRM guidelines.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Chart review.
  
  
  RESULTS
  Analysis of the group (n = 44) showed 52% were male, with 61% of children affected on the left side, and 73% having a transverse deficiency. Compliance to individual aspects of the guidelines varied considerably. Only 14 (32%) of children had met with the multidisciplinary team by the recommended age of six months. Analysis of referral sources and timings suggested that children were initially seen elsewhere and later referred to RDS after consultation with a surgeon.
  
  
  CONCLUSIONS
  RDS compliance with the BSRM guidelines was variable. Particularly disappointing was the low rate of children and families meeting the multidisciplinary team at an early age (< 6 months). The low rate of early referral prompted us to contact all paediatricians in Northern Ireland highlighting the guidelines, the benefits of early contact with RDS and encouraging referral on diagnosis.
authors.affiliation: Musgrave Park Hospital, Belfast, UK. josephinehillan@doctors.net.uk
authors.forename: Josephine
authors.initials: J
authors.lastname: Hillan
authors.forename: Lorraine E
authors.initials: LE
authors.lastname: Graham
mesh_terms: D000674:Amputees / Q000534:rehabilitation*; D001186:Artificial Limbs; D002662:Child Health Services / Q000592:standards*; D002675:Child, Preschool; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D017880:Limb Deformities, Congenital / Q000628:therapy*; D008297:Male; D009660:Northern Ireland; D010372:Pediatrics; D017410:Practice Guidelines as Topic; D012017:Referral and Consultation; D012189:Retrospective Studies