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An International Survey of the Structure and Process of Care for Traumatic Spinal Cord Injury in Acute and Rehabilitation Facilities: Lessons Learned From a Pilot Study Publisher Pubmed



Abedi A1 ; Bieringsorensen F2 ; Chhabra HS3 ; Dandrea Greve JM4 ; Khan NM5 ; Koskinen E6 ; Kwan KYH7 ; Liu N8 ; Middleton JW9 ; Moslavac S10 ; Rahimimovaghar V11 ; Oconnell C12 ; Previnaire JG13 ; Patel A14 Show All Authors
Authors
  1. Abedi A1
  2. Bieringsorensen F2
  3. Chhabra HS3
  4. Dandrea Greve JM4
  5. Khan NM5
  6. Koskinen E6
  7. Kwan KYH7
  8. Liu N8
  9. Middleton JW9
  10. Moslavac S10
  11. Rahimimovaghar V11
  12. Oconnell C12
  13. Previnaire JG13
  14. Patel A14
  15. Scivoletto G15
  16. Sharwood LN16
  17. Townson A17
  18. Urquhart S18
  19. Vainionpaa A19
  20. Zaman AU20
  21. Noonan VK21
  22. Cheng CL21
Show Affiliations
Authors Affiliations
  1. 1. Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
  2. 2. Department for Spinal Cord Injuries, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
  3. 3. Indian Spinal Injuries Centre, New Delhi, India
  4. 4. Medical School University of Sao Paulo, Sao Paulo, Brazil
  5. 5. Orthopedic Surgery Department, Hamad General Hospital, Doha, Qatar
  6. 6. Department of Neurology and Rehabilitation, Tampere University Hospital, Tampere, Finland
  7. 7. Department of Orthopaedics & Traumatology, Faculty of Medicine, University of Hong Kong, SAR, Hong Kong
  8. 8. Department of Rehabilitation Medicine, Peking University Third Hospital, Beijing, China
  9. 9. John Walsh Centre for Rehabilitation Research, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
  10. 10. Post-acute and Palliative Care Department Novi Marof, General Hospital Varazdin, Varazdin, Croatia
  11. 11. Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
  12. 12. Physical Medicine & Rehabilitation, Dalhousie University Faculty of Medicine, Fredericton, NB, Canada
  13. 13. Fondation Hopale, Berck sur Mer, France
  14. 14. Middlemore Hospital, Auckland, New Zealand
  15. 15. Spinal Unit and Spinal Rehabilitation (SpiRe) Lab, IRCCS Fondazione S. Lucia, Rome, Italy
  16. 16. University of Sydney, Sydney, NSW, Australia
  17. 17. Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
  18. 18. Spinal Injuries Unit, Queensland Spinal Cord Injuries Services, Brisbane, QLD, Australia
  19. 19. Department of Medical Rehabilitation, Oulu University Hospital, Oulu, Finland
  20. 20. Lahore Medical and Dental College, Ghurki Trust Teaching Hospital, Lahore, Pakistan
  21. 21. Praxis Spinal Cord Institute, Vancouver, BC, Canada

Source: BMC Health Services Research Published:2022


Abstract

Background: To describe the key findings and lessons learned from an international pilot study that surveyed spinal cord injury programs in acute and rehabilitation facilities to understand the status of spinal cord injury care. Methods: An online survey with two questionnaires, a 74-item for acute care and a 51-item for rehabilitation, was used. A subset of survey items relevant to the themes of specialized care, timeliness, patient-centeredness, and evidence-based care were operationalized as structure or process indicators. Percentages of facilities reporting the structure or process to be present, and percentages of indicators met by each facility were calculated and reported separately for facilities from high-income countries (HIC) and from low and middle-income countries (LMIC) to identify “hard to meet” indicators defined as those met by less than two-thirds of facilities and to describe performance level. Results: A total of 26 acute and 26 rehabilitation facilities from 25 countries participated in the study. The comparison of the facilities based on the country income level revealed three general observations: 1) some indicators were met equally well by both HIC and LMIC, such as 24-hour access to CT scanners in acute care and out-patient services at rehabilitation facilities; 2) some indicators were hard to meet for LMIC but not for HIC, such as having a multidisciplinary team for both acute and rehabilitation settings; and 3) some indicators were hard to meet by both HIC and LMIC, including having peer counselling programs. Variability was also observed for the same indicator between acute and rehabilitation facilities, and a wide range in the total number of indicators met among HIC facilities (acute 59–100%; rehabilitation 36–100%) and among LMIC facilities (acute: 41–82%; rehabilitation: 36–93%) was reported. Conclusions: Results from this international pilot study found that the participating acute and rehabilitation facilities on average adhered to 74% of the selected indicators, suggesting that the structure and processes to provide ideal traumatic spinal cord injury care were broadly available. Recruiting a representative sample of SCI facilities and incorporating regional attributes in future surveys will be helpful to examine factors affecting adherence to indicators. © 2022, The Author(s).