Improving spine surgical access, appropriateness and efficiency in metropolitan, urban and rural settings

Zarrabian, Mohammad; Bidos, Andrew; Fanti, Caroline; Young, Barry R. De; Drew, Brian; Puskas, David; Rampersaud, Raja

doi:10.1503/cjs.016116

Cited by 24 publications

(36 citation statements)

References 35 publications

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“…They showed a marked decrease in MRI referrals and reduced surgical candidates’ waiting times for consultation appointments with a spine surgeon. Another successful Canadian implementation programme showed similar results while maintaining a patent satisfaction rate of 97% [ 29 , 30 ]. Both of these implementation programmes yielded marked reductions in the cost of care for patients with LBP.…”

Section: A Logic Model For Decreasing the Mri Rate Of Persons Withmentioning

confidence: 84%

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Development of a Logic Model for a Programme to Reduce the Magnetic Resonance Imaging Rate for Non-Specific Lower Back Pain in a Tertiary Care Centre

et al. 2021

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Tertiary care centres continue to experience over-utilisation of diagnostic imaging services for lower back pain cases that may not be required. Moreover, these services may require additional time and consequently delay access to services that offer conservative management, i.e., physiotherapy, and hence, increase the direct and indirect costs with no added quality of care. A logic model was developed based on qualitative and quantitative studies that explains the plan and process evaluation strategies to reduce imaging for lower back pain in tertiary hospitals. Logic models are useful tools for defining programme components. The delivery of the components is ensured by well-defined process evaluations that identify any needed modifications. The proposed logic model provides a road map for spine clinics in tertiary care hospitals to decrease the number of patient referrals for magnetic resonance imaging and waiting times for consultations and services and promote early access to physiotherapy services.

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Section: A Logic Model For Decreasing the Mri Rate Of Persons Withmentioning

confidence: 84%

“…The target percentages were estimated based on implementation studies conducted in Canada [ 28 , 29 , 30 ].…”

Section: A Logic Model For Decreasing the Mri Rate Of Persons Withmentioning

confidence: 99%

Development of a Logic Model for a Programme to Reduce the Magnetic Resonance Imaging Rate for Non-Specific Lower Back Pain in a Tertiary Care Centre

et al. 2021

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“…The mixed methods article (Cheshire, Polley, Peters, & Ridge, 2013) used a single sample design. Of the 11 quantitative articles, six were randomised controlled trials (Cherkin et al, 2018; Darlow et al, 2019; Gannon et al, 2019; Goertz et al, 2017; Hill et al, 2011; Riis et al, 2016), one was a non‐randomised controlled trial (Murphy, Blake, Power, & Fullen, 2016), one was a before and after sequential design (Foster et al, 2014), two were retrospective designs (Wilgenbusch, Wu, & Fourney, 2014; Zarrabian et al, 2017) and one was a longitudinal design (Jess et al, 2018).…”

Section: Resultsmentioning

confidence: 99%

A systematic scoping review of patient health outcomes and perceptions following management of low back pain via care pathways in primary health care

Boyle

Fary

Kang

et al. 2020

Musculoskeletal Care

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Background Emerging evidence suggests that although care pathways for people with low back pain (LBP) improve health outcomes, there is a limited adoption/uptake of these pathways in primary care. To help identify and/or explain barriers and facilitators to implementation, research study designs applying a mixed methods approach including robust qualitative methodology may provide a more comprehensive understanding of patient health outcomes and patient perceptions of care. Methods A systematic search of MEDLINE, OVID EMBASE, Cumulative Index to Nursing and Allied Health Literature and Scopus (1980–2020) was conducted to identify relevant mixed methods, quantitative and qualitative studies. Results Three hundred and sixteen articles were screened for inclusion, with a total of 12 articles (1 mixed methods and 11 quantitative) included in the review. No solely qualitative studies were found. Broadly, patients reported overall improved health outcomes and higher satisfaction using the care pathway. In the mixed methods study, engaging patients in aspects of care were reported to be challenging. Further, while patient health outcomes (quantitative) and patient experiences of the care pathway (qualitative—free‐text survey responses) were presented separately, a lack of detailed convergence/triangulation of the data limits conclusions that could inform implementation into clinical settings. Conclusion Data supported the positive effect of care pathways on patient health outcomes, yet investigation of the patient experience was limited. Only one study used a mixed methods design and then only used free‐text survey responses for the qualitative component. Future efforts to integrate LBP care pathways into primary care may benefit from using mixed methods design with an emphasis on robust qualitative methodology.

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“…132 Other national and regional quality improvement programs have been instituted. 19,20,138,139 Given the scope of this review, individual programs will not be discussed in detail. At the institutional level, however, execution of the quality improvement program usually faces barriers to implementation.…”

Section: Quality Improvement Initiativementioning

confidence: 99%

Quality and Safety Improvement in Spine Surgery

Jiang

Wilson

Badhiwala

et al. 2020

Global Spine Journal

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Study Design: Review article. Objectives: A narrative review of the literature on the current advances and limitations in quality and safety improvement initiatives in spine surgery. Methods: A comprehensive literature search was performed using Ovid MEDLINE focusing on 3 preidentified concepts: (1) quality and safety improvement, (2) reporting of outcomes and adverse events, and (3) prediction model and practice guidelines. The search was conducted under appropriate subject headings and using relevant text words. Articles were screened, and manuscripts relevant to this discussion were included in the narrative review. Results: Quality and safety improvement remains a major research focus attracting investigators from the global spine community. Multiple databases and registries have been developed for the purpose of generating data and monitoring the progress of quality and safety improvement initiatives. The development of various prediction models and clinical practice guidelines has helped shape the care of spine patients in the modern era. With the reported success of exemplary programs initiated by the Northwestern and Seattle Spine Team, other quality and safety improvement initiatives are anticipated to follow. However, despite these advancements, the reporting metrics for outcomes and adverse events remain heterogeneous in the literature. Conclusion: Constant surveillance and continuous improvement of the quality and safety of spine treatments is imperative in modern health care. Although great advancement has been made, issues with reporting outcomes and adverse events persist, and improvement in this regard is certainly needed.

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Improving spine surgical access, appropriateness and efficiency in metropolitan, urban and rural settings

Cited by 24 publications

References 35 publications

Development of a Logic Model for a Programme to Reduce the Magnetic Resonance Imaging Rate for Non-Specific Lower Back Pain in a Tertiary Care Centre

Development of a Logic Model for a Programme to Reduce the Magnetic Resonance Imaging Rate for Non-Specific Lower Back Pain in a Tertiary Care Centre

A systematic scoping review of patient health outcomes and perceptions following management of low back pain via care pathways in primary health care

Quality and Safety Improvement in Spine Surgery

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