Implementing Evidence-based Motor Assessments of Infants at High Risk for Cerebral Palsy: A Quality Improvement Initiative

In 2017, international guidelines for utilization of evidence-based assessments for early detection of cerebral palsy (CP) in infants less than two years old was published. Within these guidelines, the General Movements Assessment (GMA) was identified as the most valid assessment for early diagnosis of CP in an infant less than five months old. Infants who demonstrate neonatal risk factors requiring admission to the newborn intensive care unit (NICU) are at highest risk for CP. Early detection of CP is vital for initiation of CP-specific interventional therapies which have the potential to improve a child’s motor skills and functional mobility.
Implementation of the guidelines across multiple settings within a large medical center requires standardization of processes, those of which are met with barriers along the way. The presenters will discuss the utilization of multiple quality improvement tools including process maps, key driver diagrams, and plan-do-study-act cycles which proved to be crucial for implementation of the GMA in the NICU and NICU Follow-up clinic settings. Run charts which detail the progression of GMA completion percentage in each setting based on the interventions will be shared. Participants will have the opportunity to begin applying the identified quality improvement tools for use in their own clinical setting to support early detection of CP.