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This initiative focuses on improving early diagnosis and management of Developmental Dysplasia of the Hip (DDH) in children, a condition that can lead to lifelong disability if not detected early. Despite screening programs, late diagnoses are still evident. The program targets frontline clinicians, providing standardized clinical examination guidelines and education to enhance their skills, confidence, and referral procedures. By utilizing multimedia learning resources, we aim to foster knowledge and create consistent practices across healthcare professionals to improve child health outcomes.
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Multimedia Health Education Can It Change Clinical Practice?Assoc Prof Leo DonnanDirector of Orthopaedics Chief of Surgery RCH
What is DDH? • A condition of the childs hip where there is incomplete development • Range of disorders including - instability, subluxation and dislocation
If unstable hips are not detected and treated they may - not develop properly and eventually fail
The Impetus to do something • In Victoria children are still presenting with a late diagnosis of hip dislocation despite screening programs and use of ultrasound • Children facing lifelong disability from a condition that is easily managed if detected early
Victorian Screening Program • 72,000 births per year • Geographically Spread • 4.0 million in Melbourne • 2.0 million in the “bush”
Clinical examination • at birth • six weeks • regular intervals up to age two • Ultrasound • abnormal clinical findings • risk factors at six weeks
The Problem • Poor documentation • No uniform standard of examination • Inconsistency in terminology • Increased reliance on imaging • Unclear referral mechanisms • Multiple examiners
The Scale of things • 72,000 births per year • Expect • 72 frank dislocations • 720 unstable hips • ???? dysplastic hips • 1012 MCH nurses in full/part time positions • large work force • dispersed • will see very low rates of dislocation • hrad to maintain skills
The Solution ? • Target the front line clinicians • Understand their difficulties • Define the barriers to early detection • Develop evidence based practice guidelines • Standardise the clinical examination • Apply education theory principles
Objectives • Knowledge - terminology, anatomy, pathology, associations, risk factors, examination, imaging • Change practice - improve clinical skills, confidence and referral procedures • Standardise approach - consistency across all health professionals
Learning Ability • Education level • Cultural background • Social class • Literacy skills • Trust in the information • Emotional state
information flow Challenge High ANXIETY BOREDOM Skill Low High
Learning Types • Visual • Auditory • Written • Kinesthetic
Pictures Words Sound
Developing the Module • Focus groups • Literature review • Educational objectives • Outcome measures • Script development • Story board • Animation • Testing
Testing the Module • Maternal and Child Health Nurses • Range of municipalities • 203 recruited
P< 0.001 P< 0.001
What now? • Increase accessibility of module • online resource • roll out to other clinical groups • general practitioners • midwives • paediatricians • Update the module • response to feedback • Watch for changes • swaddling module developed
Swaddling • Recent trend for settling babies • What’s old is new again!! • High risk for DDH if not practiced safely
Has it made a difference? MOR at RCH (year to date)
Summary • This initiative is aimed at improving the health and well being of children by facilitating early diagnosis and referral of DDH • The module significantly improves the clinicians knowledge, skills and confidence in making the diagnosis • Aim to ultimately reduce the need for complex surgery due to late diagnosis
Take Home • Refresh your knowledge • Update your skills • Use the resources
