{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T13:36:33Z","timestamp":1771076193143,"version":"3.50.1"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Background. The American Physical Therapy Association (APTA) published a guideline for congenital muscular torticollis (CMT) in 2013. Our division adopted the guideline as the institutional practice standard and engaged in a quality improvement (QI) initiative to increase the percentage of patients who achieved resolution of CMT within 6 months of evaluation.<\/jats:p>\n               <jats:p>Objective. The aims of this report are to describe the QI activities conducted to improve patient outcomes and discuss the results and implications for other institutions and patient populations.<\/jats:p>\n               <jats:p>Design. This was a quality improvement study.<\/jats:p>\n               <jats:p>Methods. In alignment with the Chronic Care Model and Model of Improvement, an aim and operationally defined key outcome and process measures were established. Interventions were tested using Plan-Do-Study-Act cycles. A CMT registry was established to store and manage data extracted from the electronic record over the course of testing. Statistical process control charts were used to monitor progress over time.<\/jats:p>\n               <jats:p>Results. The QI initiative resulted in an increase in the percentage of patients who achieved full resolution of CMT within a 6-month episode of care from 42% to 61% over an 18-month period. Themes that emerged as key drivers of improvement included: (1) timely, optimal access to care, (2) effective audit and clinician feedback, and (3) accurate, timely documentation.<\/jats:p>\n               <jats:p>Limitations. The initiative took place at a single institution with a supportive culture and strong QI resources, which may limit direct translation of interventions and findings to other institutions and patient populations.<\/jats:p>\n               <jats:p>Conclusions. Improvement science methodologies provided the tools and structure to improve division-wide workflow and increase consistency in the implementation of the APTA CMT guideline. In doing so, significant CMT population outcome improvements were achieved.<\/jats:p>","DOI":"10.1093\/ptj\/pzx029","type":"journal-article","created":{"date-parts":[[2017,3,14]],"date-time":"2017-03-14T20:50:58Z","timestamp":1489524658000},"page":"649-658","source":"Crossref","is-referenced-by-count":17,"title":["Implementation of a Quality Improvement Initiative: Improved Congenital Muscular Torticollis Outcomes in a Large Hospital Setting"],"prefix":"10.1093","volume":"97","author":[{"given":"Mariann L.","family":"Strenk","sequence":"first","affiliation":[{"name":"M.L. Strenk, PT, DPT, MHS, Division of Occupational and Physical Therapy, Cincinnati Children's Hospital Medical Center, 3430 Burnet Ave, Cincinnati, OH 45229 (USA)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Kiger","sequence":"additional","affiliation":[{"name":"M. 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