Utilizing an Interprofessional Team to Develop an Evaluation and Monitoring Outcome Tool for a Pediatric Surgical Rehabilitation Program in Tanzania

Abstract

Objectives To describe a medical assessment tool developed to track patient outcomes for post-operative, rehabilitative pediatric care in efforts to effectively collect evaluation and monitoring data in a limited resource setting. Methods The Plaster House in Arusha, Tanzania partnered with an interdisciplinary academic team (dietetics, nursing, occupational therapy, physical therapy, physician assistant, public health, and social work) from St. Catherine University (St. Paul, MN, USA). Through an 18-month iterative process, the team created an assets map, logic model and evaluation plan. To measure goals in the logic model, an assessment tool was developed to monitor and evaluate patient post-operative recovery for children with cleft lip/palate, spina bifida, skeletal fluorosis, osteomyelitis, burn scar contractures, or clubfoot. Diagnosis-specific indicators were determined collaboratively using evidence-based measures the team agreed would be simple to collect and reliable when different team members collect the measurement. Results The tool evaluates nutritional status, one diagnosis-specific indicator, and three developmental indicators recorded at intake and discharge. For example, a child with spina bifida is evaluated on bladder and bowel continence. If the child is incontinent of bladder or bowel, the tool asks whether management of the incontinence is child managed, parent managed, or not managed. The developmental indicators assess age-appropriate level assessment of everyday tasks, such as activities of daily living, play, and social interaction. Conclusions The medical assessment tool serves multiple purposes for the pediatric rehabilitation program, including monitoring participants’ progress, evaluating the effectiveness of current practices, and sharing data with funders.This medical assessment tool has the potential to feasibly capture outcome measurements post-operation on seven correctable disabilities for pediatric rehabilitative care facilities with limited resources. Funding Sources GHR Foundation.