KPI for alveolar bone grafting in cleft lip and palate services.
Cleft services aim to provide surgery and specialist care for patients to achieve an aesthetic and functional facial appearance. Alveolar bone grafting (ABG) forms part of this care pathway as described in the cleft service specification document.
Bone graft requirements state all children requiring alveolar bone grafting will receive the treatment at optimum times and with satisfactory results.
- Key performance indicator 1:is the recording of the percentage of children in a single year who have an alveolar defect and who are assessed by a cleft team orthodontist and surgeon responsible for alveolar bone grafting between 7 years and before the age of 9 years.
- Key performance indicator 2: is the quality of the graft. Bone graft results will be assessed by the Kindelan score at 6 months post-operative based on an oblique occlusal radiograph of each ABG carried out in a designated year as part of their routine protocol of care in children having their first bone graft at less than 16 years of age. Bone graft results can also be assessed by clinical examination of the alveolar cleft.
- Key performance indicator 3: the provision of any associated orthodontics required pre or post ABG.
The cleft service will complete/upload data for these ABG key performance indicators to the national specialised services quality dashboard. Centres will also participate in regional and national audits and contribute data required by CRANE (the national cleft database), the Quality Dashboard and the Tri/Quad centre audit groups.
These KPI’s are stated in the cleft specification document. However currently there is no recording of outcomes and/or treatment delay.
BAOMS would support ABG outcomes being formally recorded by CRANE.