Scoring System to Triage Patients for Spine Surgery in the Setting of Limited Resources

Sciubba, Daniel M.; Ehresman, Jeffrey; Elsamadicy, Aladine A.; Goodwin, Matthew L.; Huq, Sakibul; Neumaan, Brian J.; Passias, Peter G.; Protopsaltis, Themistocles S.; Do, Nicholas T; Benzel, Edward C.

doi:10.1093/neuros/nyaa447_684

Neurosurgery

2020

DOI: 10.1093/neuros/nyaa447_684

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Scoring System to Triage Patients for Spine Surgery in the Setting of Limited Resources

Daniel M. Sciubba¹,

Jeffrey Ehresman²,

Aladine A. Elsamadicy³

et al.

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Cited by 2 publications

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“…This is particularly true for neurosurgical pathologies, many of which benefit from semi-urgent management. 8 The increased availability of telehealth services 7,9 serves as one potential solution that can help to enable delivery of care while limiting the spread of COVID-19.…”

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confidence: 99%

Positive impact of the pandemic: the effect of post–COVID-19 virtual visit implementation on departmental efficiency and patient satisfaction in a quaternary care center

Pennington

Michalopoulos

Biedermann³

et al. 2022

Neurosurgical Focus

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OBJECTIVE The coronavirus disease 2019 (COVID-19) pandemic has significantly changed clinical practice across US healthcare. Increased adoption of telemedicine has emerged as an alternative to in-person contact for patient-physician interactions. The aim of this study was to analyze the impact of telemedicine on workflow and care delivery from January 2019 to December 2021 in a neurosurgical department at a quaternary care center. METHODS Prospectively captured data on clinic appointment utilization, duration, and outcomes were queried. Visits were divided into in-person visits and telemedicine appointments, categorized as follow-up visits of previously surgically treated patients, internal consultations, new patient visits, and early postoperative returns after surgery. Appointment volume was compared pre- and postpandemic using March 2020 as the pandemic onset. Clinical efficiency was measured by time to appointment, rate of on-time appointments, proportion of appointments resulting in surgical intervention (surgical yield), and patient-reported satisfaction, the latter measured as the proportion of patients indicating “high likelihood to recommend practice.” RESULTS A total of 54,562 visits occurred, most commonly for follow-up for previously operated patients (51.8%), internal new patient referrals (24.5%), and external new patient referrals (19.8%). Total visit volume was stable pre- to postpandemic (1521.3 vs 1512, p = 0.917). However, in-person visits significantly decreased (1517/month vs 1220/month, p < 0.001), with a nadir in April 2020, while telemedicine appointment utilization increased significantly (0.3% vs 19.1% of all visits). Telemedicine utilization remained stable throughout the 1st calendar year following the pandemic. Telemedicine appointments were associated with shorter time to appointment than in-person visits both before and after the pandemic onset (0–5 days from appointment request: 60% vs 33% vs 29.8%, p < 0.001). Patients had on-time appointments in 87% of telemedicine encounters. Notably, telemedicine appointments resulted in surgery in 31.8% of internal consultations or new patient visits, a significantly lower rate than that for in-person visits (51.8%). After the widespread integration of telemedicine, patient satisfaction for all visits was higher than before the pandemic onset (85.9% vs 88.5%, p = 0.027). CONCLUSIONS Telemedicine use significantly increased following the pandemic onset, compensating for observed decreases in face-to-face visits. Utilization rates have remained stable, suggesting effective integration, and delays between referrals and appointments were lower than for in-person visits. Importantly, telemedicine integration was not associated with a decrease in overall patient satisfaction, although telemedicine appointments had a lower surgical yield. These data suggest that telemedicine smoothened the impact of the pandemic on clinical workflow and helped to maintain continuity and quality of outpatient care.

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confidence: 99%

Positive impact of the pandemic: the effect of post–COVID-19 virtual visit implementation on departmental efficiency and patient satisfaction in a quaternary care center

Pennington

Michalopoulos

Biedermann³

et al. 2022

Neurosurgical Focus

Self Cite

View full text Add to dashboard Cite

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In Defense of Our Patients: Indirect Negative Neurological Consequences of SARS-CoV-2 in the New York Epicenter

Cooper

Amin

Kim

et al. 2020

Journal of Stroke and Cerebrovascular Diseases

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Scoring System to Triage Patients for Spine Surgery in the Setting of Limited Resources

Cited by 2 publications

References 0 publications

Positive impact of the pandemic: the effect of post–COVID-19 virtual visit implementation on departmental efficiency and patient satisfaction in a quaternary care center

Positive impact of the pandemic: the effect of post–COVID-19 virtual visit implementation on departmental efficiency and patient satisfaction in a quaternary care center

In Defense of Our Patients: Indirect Negative Neurological Consequences of SARS-CoV-2 in the New York Epicenter

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