Infant cranial ultrasound: Applying practice development principles to enhance service delivery
Introduction
Health care services which reflect the best interests of patients and carers are an important component of contemporary service provision (Chin and McNichol, 2000). Any evaluation of health care delivery should consider impact at practitioner, patient, service delivery and organisational levels (Page and Hamer, 2002).
This study was undertaken at a secondary care provider (District General Hospital) which has a strategic objective to provide evidenced based accessible care close to the patient's home (Beard, 2010). The aim of the study was to assess the feasibility of improving diagnostic outcomes by creating an infant cranial ultrasound service at a similar level of technical complexity to that delivered at a geographically distant tertiary referral center.
The emancipatory ‘Practice Development’ methods employed in this study are characterised by a transformational culture, a shared vision for positive change, shared responsibility and staff development perspectives (Manley and McCormack, 2003).
Section snippets
Background
Diagnostic tests are used to establish and monitor the presence of disease, inform treatment and assess prognosis (Mant, 2005). Infant Cranial Ultrasound (CUS) is performed to assess and monitor the infant brain (Maalouf et al., 2001). It can be performed in infants up to approximately 15 months of age (Siegel, 2007) but is most commonly used in the neonatal period (Larroque et al., 2003) where it helps guide clinical management and provides a basis for long term prognosis of neurodevelopmental
Methods
Practice Development (PD) is a term used to describe methods for developing healthcare practice (Manley et al., 2008). Historically its nature and scope is poorly defined (Unsworth, 2000), however, more recently the term has become associated with the concepts of continuous quality improvement and excellence in practice (McSherry and Warr, 2006).
In this study PD was operationalised in six stages.
Acknowledgement
This study was conducted in partial fulfillment for the award of MSc Medical Ultrasound at the University of Leeds.
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