Team Decision Planning
At Wake Forest University Baptist Medical Center (WFUBMC), we utilize team directed care to increase the efficiency and overall outcome effectiveness of our treatment plans. Each specialist within the team plays a crucial role for successful treatment. It is not only is it imperative to have the expertise of specialists as a part of this team, but also to have the patient’s family as an integral team member. At WFUBMC, we know that it is important to rely on your child’s primary care physician and other professionals who play an active role in the patient’s life.
By using the multiple discipline team concepts, we are able to maintain up-to-date knowledge of current techniques needed for optimal care. When rotating through a typical clinic, the patient will see a variety of specialists in one visit. This enables us to decrease the number of visits to the medical center and to better coordinate the treatment plan. The patient is likely to come in contact with:
Craniofacial Surgeon:
The craniofacial surgeon is a specialized plastic surgeon in the area of diagnosing and treating skeletal abnormalities of the skull and facial bones. Common responsibilities and skills include:
· Reconstructing deficiencies of the bone and soft tissue of the face, including cleft lip and palate repairs, and traumatic and congenital soft tissue defects
· Managing prematurely fused cranial sutures (craniosynostosis)
· Working with other team members on planning and performing cranial
· nd midface advancement procedures
· Implementing distraction osteogenesis for a variety of conditions
Performing local and distant flaps to reconstruct facial defects
Pediatric Neurosurgeon:
The pediatric neurosurgeon specializes in the growth and development of the brain and cranium. Some aspects of the pediatric neurosurgeon’s role are:
· Assisting the craniofacial surgeon in surgeries that involve releasing and repositioning all abnormal skull structures
· Treating patients with hydrocephalus, as well as those patients with traumatic injuries affecting the skull or brain
· Monitoring cranial growth before and after surgery
Otolaryngologist:
The otolaryngologist is specially trained to treat abnormalities of the ear canal and airway difficulties. The otolaryngologist involvement includes:
- Serving as the team’s airway expert for children with anomalies impairing their airway
- Coordinating medical and surgical therapy with the team to improve the child’s hearing, especially to help ensure normal speech development
- Assisting in the treatment of children with head and neck tumors
Hearing and Speech Therapists:
Our team consists of both an audiologist and a speech-language pathologist. The audiologist’s primary role is performing audiological assessments, including those for middle-ear functioning, auditory brainstem response, central auditory processing and hearing-aid evaluation and treatment. Our speech-language pathologist evaluates and treats patients both before and after surgery. The pathologist, through diagnostic testing, can identify speech problems. They can also perform computerized speech assessments and assist in evaluating long-term outcomes.
Orthodontist:
The orthodontist serves as the structural diagnostician of the mouth. The primary concern is the growth and development of the face, and how it affects the position of the teeth. The orthodontist’s areas of expertise include:
- Analyzing radiographs and other diagnostic measures to identify anatomic abnormalities
- Modifying jaw growth and aligning teeth
- Palatal expansion
Pediatric Dentist:
Our pediatric dentist’s team role involves:
- Specializing in the dental needs for various conditions that result in duplicate, missing, or deformed teeth
- Coordinating dental care at the time of other surgical treatments
Geneticist:
The geneticist looks for an identifiable cause for a deformity and assists in the diagnosis of complex conditions. Their role includes:
- Evaluating the patient’s background by reviewing the medical and family history, as well as completing an examination
- Addressing questions patients or families have concerning the etiology of craniofacial disorders
- If applicable, obtaining chromosomal studies
- Discussing the risks for a recurring disorder and options for prenatal monitoring and detection
Clinical Coordinator:
The team coordinator orchestrates each individual child’s needs with the multiple resources of the entire craniofacial team. They are committed to:
- Managing initial appointments
- Coordinating appointments to ensure patients are seen by all team members
- Scheduling procedures and equipment needed for treatment plans
- Assisting with social issues such as helping with accommodations during prolonged hospital stays, and better acquainting families with the medical center
- Maintaining the craniofacial database so each patient receives proper follow-up.
When these specialists work together, and with the family, as an interdisciplinary team, treatment goals can be individualized for each child, and parents and health care providers can make the best choices for treatment by consulting with each other. Since growth is a significant factor in the ultimate outcome of treatment, the team must assess the child thoroughly and regularly until young adulthood.