Guideline Adherence Crucial to Improving Outcomes for Infants with Congenital Muscular Torticollis

Published March 24, 2017
Journal of Physical Therapy

Congenital muscular torticollis (CMT) is a condition that occurs in infants and may be related to many factors, including in utero position, birth trauma, or a multiple birth. It is characterized by muscle tightness that causes a baby’s head to tilt to one side.

Early identification and physical therapy can result in complete resolution, reducing the need for further interventions, including surgery. However, wide variations in the timeliness of care have prevented achievement of positive results. Thus, a quality improvement initiative was launched.

Mariann Strenk, PT, DPT, MHS, and Michelle Kiger, OTR/L, MHS, Division of Occupational Therapy and Physical Therapy, and team senior analyst Jesse Hawke, PhD, James M. Anderson Center for Health Excellence, played key roles in improving training, aligning resources, and analyzing data.

The research team reported achieving a 61 percent success rate for complete resolution of CMT within six months. Pre-study, the rate was 42 percent.

Three key factors drove improvement: 1) timely, optimal access to care, 2) effective audit and clinician feedback, 3) accurate, timely documentation.

Strenk and Kiger say that improvement science methodologies helped them perform a critical evaluation of current systems and implement a clinical practice guideline.

“Understanding the complexities of processes and testing small changes facilitated meaningful adjustments and increased reliability within the system," they reported.

“It is gratifying to see the knowledge translation gap between research and clinical care narrowed by effectively applying improvement science methodologies,” they say. “Within our division, we intend to strategically implement improvement science methodologies with other conditions in order to drive improvements in patient outcomes, experience, and value.”