Pediatrics & Prospective Surveillance Model – How to Make It Work

We probably all know about the Prospective Surveillance Model (PSM), but have you ever thought about implementing PSM for pediatrics?

I invited Dr. Nashwa Khalil & Dr. Lynn Tanner, two pediatric oncologic PTs, on to TheOncoPT Podcast to discuss how cancer rehab helps pediatric patients, how Prospective Surveillance Model works in the pediatric setting, & some of the barriers they encountered when putting the research into practice.

In this CSM preview, Nashwa & Lynn really broke down strategies that helped them get system-wide buy-in of PSM, plus the key relationships that really helped solidify PSM as standard of care in their institution.

Pediatric patients experience side effects & impairments, just like our adult patients

Children with cancer can experience a variety of physical impairments as a result of cancer treatment. Chemotherapy and radiation therapy can cause fatigue, weakness, and decreased endurance. Surgery may result in loss of range of motion, strength, or sensation. 

Additionally, cancer and its treatments may also cause developmental delays, balance and coordination issues, and difficulty with fine or gross motor skills. Physical impairments can impact a child’s ability to participate in daily activities and affect their overall quality of life.

Patients benefit from cancer rehab, regardless of their age

Rehab can provide numerous benefits for children with cancer. It can help maintain and improve physical function, reduce pain and discomfort, increase endurance and strength, and improve overall quality of life. We can also work with children to set achievable goals and provide personalized treatment plans to help them recover and regain their strength during and after cancer treatment.

It’s also important to remember that children are also growing & developing, so developmental milestones may be delayed, interrupted, or missed altogether due to cancer & cancer treatments.  This can have significant implications for a child’s overall health & wellness, not just now but also for the rest of their life.

Prospective Surveillance Model (PSM) is just as important to implement in pediatrics

The prospective surveillance model in pediatric cancer rehab has numerous benefits. First, PSM allows for early detection of potential physical impairments, which can help prevent or minimize their impact on a child’s overall function and quality of life. The model also allows for more targeted interventions to address any issues as they arise, improving outcomes and reducing the need for more extensive or invasive treatments down the line. 

Finally, the model helps to improve communication between healthcare providers, families, and patients, resulting in more coordinated and effective care.  As Nashwa discussed, over 80% of pediatric patients undergoing vincristine will develop some kind of neuropathy.  So why not monitor for these impairments from the start & intervene early?  

Implementing PSM into pediatric oncology care does have some barriers

While the prospective surveillance model is highly beneficial for pediatric oncology patients, there are several barriers to its implementation. These include a lack of standardized screening protocols, limited availability of specialized pediatric rehabilitation services, insurance coverage limitations, and limited access to resources in some geographical areas. 

Additionally, there may be barriers related to patient and family engagement, such as a lack of understanding about the importance of rehabilitation or concerns about the time and cost involved. Addressing these barriers will require a multi-disciplinary approach and a commitment to improving access to rehabilitation services for pediatric cancer patients

Every system will have barriers to implementing PSM in pediatric oncology rehab, but it is possible AND necessary.

Catch their session The Trifecta for Success: Building a Pediatric Oncology Rehabilitation Program From the Ground Up on Thursday, February 23 at 11am!

Their session will go over the nuts & bolts of how their team really implemented prospective surveillance model in their pediatric oncology population

Until next time, this is Elise with TheOncoPT. And remember you are exactly the physical therapist that your patients with cancer need. So let’s get to work.

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