The role of specialist units to provide focused care and complication avoidance following traumatic spinal cord injury: a systematic review

Maharaj, Monish; Hogan, Jarred; Phan, Kevin; Mobbs, Ralph J.

doi:10.1007/s00586-016-4545-x

Cited by 24 publications

(19 citation statements)

References 44 publications

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“…Рассматривая эффективность организации лечебного процесса и результаты лечения пострадавших с острой ПСМТ в условиях децентрализованной системы оказания специализиро- 11,75 (11,4) C 11 (4,9) 3 (6,8) Шкала ASIA, n (%) A 9 (4,0) 2 (4,5) 0,8506 B 31 (13,9) 5 (11,4) C 21 (9 госпитализированы по поводу ПСМТ, а у остальных 1072 (77,8 %) была нетравматическая патология позвоночника, практически всецело представленная дегенеративно-дистрофическими заболеваниями (94,6 %) [8,9]. Однако даже среди этих пациентов преобладали поступившие в стационар для планового лечения данной патологии (56,1 %), а хирургическая помощь больным с острой патологией оказывалась, во-первых, по значительно суженным показаниям, а во-вторых -не в неотложном, а в отсроченном порядке [10].…”

Section: Discussionunclassified

“…Проблема позвоночно-спинномозговой травмы (ПСМТ) сохраняет высокую актуальность для любого государства [1][2][3]. Многочисленными исследованиями доказано, что залогом успешного лечения пострадавших с ПСМТ является своевременное оказание неотложной специализированной хирургической помощи, что требует создания соответствующих профильных медицинских подразделений [4][5][6].…”

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The Efficiency of the Centralized System for Delivery of Specialized Medical Care to Victims With Acute Spinal Cord Injury in a Modern Metropolis

et al. 2019

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Objective.To perform comparative assessment and identification of determinants of efficiency of the centralized system for delivery of specialized medical care to victims with acute spinal cord injury in the modern metropolis.Material and Methods.The results of specialized medical care delivered to 2283 victims with acute spinal cord injuries were studied. The comparison group (decentralized system: treatment in several multidisciplinary hospitals in St. Petersburg) included 306 patients, and study group (centralized system: treatment in a specialized urban center for emergency spinal surgery) – 1977. Comparative analysis of the results of surgical treatment included 44 patients from comparison group and 223 patients from the study group (p> 0.05). The methods of non-parametric statistics were used.Results.The centralized treatment system is characterized by a statistically significant increase in the rate of surgical activity, a manifold increase in the proportion of emergency spinal surgery (p < 0.01) and the mandatory use of modern technologies for surgical stabilization of the spine, shortening the hospital stay, as well as higher values of all indicators characterizing the results of treatment (p < 0.01).Conclusion.In a large city, the centralized system of treating victims with spinal cord injury is characterized by more efficient use of urban health resources and better treatment outcomes. The key to its successful creation and subsequent operation, in addition to the centralization of medical care with the reasonable formation and distribution of the incoming patient flow, adequate logistic support for the treatment process and the presence of highly qualified medical personnel, is the availability of modern surgical technologies in delivering specialized emergency care.

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Section: Discussionunclassified

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The Efficiency of the Centralized System for Delivery of Specialized Medical Care to Victims With Acute Spinal Cord Injury in a Modern Metropolis

et al. 2019

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“…Although the impact of subspecialization in pathology has only recently garnered interest, 21,22 the quality improvement resulting from subspecialization has been documented in other fields, such as cardiology, 23 emergency medicine, 24 gynecologic oncology, 25 pediatrics, 26,27 radiology, 28 surgery, [29][30][31] and administration. 32 Early data indicate that in pathology the subspecialist approach reduces error, increases quality, and decreases cost.…”

Section: Discussion Multisite Primary Diagnosis By Subspecialtymentioning

confidence: 99%

Integrated Pathology Informatics Enables High-Quality Personalized and Precision Medicine: Digital Pathology and Beyond

Volynskaya¹,

Chow²,

Evans³

et al. 2017

Archives of Pathology &Amp; Laboratory Medicine

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Context.-The critical role of pathology in diagnosis, prognosis, and prediction demands high-quality subspecialty diagnostics that integrates information from multiple laboratories.Objective.-To identify key requirements and to establish a systematic approach to providing high-quality pathology in a health care system that is responsible for services across a large geographic area.Design.-This report focuses on the development of a multisite pathology informatics platform to support highquality surgical pathology and hematopathology using a sophisticated laboratory information system and whole slide imaging for histology and immunohistochemistry, integrated with ancillary tools, including electron microscopy, flow cytometry, cytogenetics, and molecular diagnostics.Results.-These tools enable patients in numerous geographic locations access to a model of subspecialty pathology that allows reporting of every specimen by the right pathologist at the right time. The use of whole slide imaging for multidisciplinary case conferences enables better communication among members of patient care teams. The system encourages data collection using a discrete data synoptic reporting module, has implemented documentation of quality assurance activities, and allows workload measurement, providing examples of additional benefits that can be gained by this electronic approach to pathology.Conclusion.-This approach builds the foundation for accurate big data collection and high-quality personalized and precision medicine.

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“…Spinal rehabilitation services have been well established over the last 20 years in UK and other developed countries, with recognised care pathways from admission to major trauma centres to spinal injury units (SIUs) following surgical stabilisation (1,2). Studies suggest improved outcomes for SCI patients managed in units that provide specialist rehabilitation, especially for those with cervical spinal cord injuries (CSCI) (3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

The experiences of individuals with cervical spinal cord injury and their family during post-injury care in non-specialised and specialised units in UK

McRae

Smith

Emmanuel

et al. 2020

Preprint

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Background Individuals with acute cervical spinal cord injury require specialised interventions to ensure optimal clinical outcomes especially for respiratory, swallowing and communication impairments. This study explores the experiences of post-injury care for individuals with cervical spinal cord injury and their family members during admissions in specialised and non-specialised units in the United Kingdom.Methods Semi-structured interviews were undertaken with individuals with a cervical spinal cord injury and their family member, focussing on the experience of care across units. Eight people with spinal cord injury levels from C2 to C6, were interviewed in their current care settings. Six participants had family members present to support them. Interviews were audio-recorded and transcribed with data inputted into NVivo for thematic analysis.Results The study identified six themes from the participant interviews that highlighted different experiences of care in non-specialised and specialised settings. A number of these were related to challenges with the system, whilst others were about the personal journey of recovery. The themes were titled as: adjustment, transitions, “the golden opportunity”, “when you can’t eat”, communication, and “in the hands of the nurses and doctors”.Conclusions Whilst participants reported being well cared for in non-specialised units, they felt that they did not receive specialist care and this delayed their rehabilitation. Participants were dependent on healthcare professionals for information and care and at times lost hope for recovery. Staff in non-specialised units require training and guidance to help provide support for those with dysphagia and communication difficulties, as well as reassurance to patients and families whilst they wait for transfer to specialised units.

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The role of specialist units to provide focused care and complication avoidance following traumatic spinal cord injury: a systematic review

Cited by 24 publications

References 44 publications

The Efficiency of the Centralized System for Delivery of Specialized Medical Care to Victims With Acute Spinal Cord Injury in a Modern Metropolis

The Efficiency of the Centralized System for Delivery of Specialized Medical Care to Victims With Acute Spinal Cord Injury in a Modern Metropolis

Integrated Pathology Informatics Enables High-Quality Personalized and Precision Medicine: Digital Pathology and Beyond

The experiences of individuals with cervical spinal cord injury and their family during post-injury care in non-specialised and specialised units in UK

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