title: The Design, Implementation, and Evaluation of a Physiotherapist-Led Clinic for Orthopedic Surveillance for Children with Cerebral Palsy.
abstract: OBJECTIVE
  To describe the development process and the evaluation results of a new physiotherapy-led clinic for orthopedic monitoring of secondary impairments for children with cerebral palsy (CP).
  
  
  METHODS
  A new clinic model was developed and implemented, guided by the Framework for the Development of Advanced Practice Roles and the Model for Improvement. Patient visits and wait-time statistics were measured during the implementation phase. Once implemented, an evaluation of the clinic model objectives was conducted. The Visit Specific Satisfaction (VSQ-9) Instrument and the Measure of Processes of Care (MPOC-20) questionnaire measured parent satisfaction, while the Collaboration and Satisfaction about Care Decisions (CSACD) surveyed staff's satisfaction. Means and frequencies described the data, and the Mann-Wittney U test was used to compare the VSQ-9 and MPOC-20 scores of the physiotherapist-led and the traditional physician-led model.
  
  
  RESULTS
  Ninety-eight additional children were seen in 1 year. Mean wait time decreased by 930 days. No statistically significant difference was demonstrated in the VSQ-9 total score (p =.84) or any of the five MPOC-20 subscales (Enabling and Partnership: p =.55; Providing General Information: p =.99; Providing Specific Information: p =.46; Coordinated and Comprehensive Care for the Child and Family: p =.33; Respective and Supportive Care: p =.86) when the two models were compared. Physiotherapist-led clinic staff members were satisfied with physician collaboration.
  
  
  CONCLUSIONS
  A physiotherapist-led clinic model for orthopedic monitoring provides increased access to service for children with CP and their families without compromising the perceived quality of care.
authors.affiliation: a Faculté de Médecine et Sciences de la Santé , Université de Sherbrooke , Sherbrooke , Québec , Canada.
authors.forename: Karen
authors.initials: K
authors.lastname: Hurtubise
authors.affiliation: b Vi Riddell Children's Pain & Rehabilitation Centre , Alberta Children's Hospital , Calgary , Alberta , Canada.
authors.forename: Robin
authors.initials: R
authors.lastname: Shanks
authors.affiliation: b Vi Riddell Children's Pain & Rehabilitation Centre , Alberta Children's Hospital , Calgary , Alberta , Canada.
authors.forename: Laura
authors.initials: L
authors.lastname: Benard
mesh_terms: D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D002547:Cerebral Palsy / Q000534:rehabilitation*; D002648:Child; D003695:Delivery of Health Care / Q000379:methods; D019988:Children with Disabilities; D006801:Humans; D008991:Monitoring, Physiologic / Q000379:methods*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D059825:Physical Therapists / Q000706:statistics & numerical data*; D015397:Program Evaluation; D011795:Surveys and Questionnaires
keywords: Cerebral palsy; orthopedic monitoring; physiotherapy; program development; program evaluation; service delivery