10 Critical Success Factors for Building a Leading Neurosurgery & Spine Program

In a session titled “Building a Leading Neurosurgery and Spine Program,” at Becker’s Hospital Review Annual Meeting on May 17 in Chicago, Casey Nolan, managing director of Healthcare Navigant, discussed the steps hospitals must take to construct a world-class neurosurgery and spine program. “We are on the cusp of this being the age of the brain,” said Mr. Nolan. “Other service lines have been developed and now it’s time for the neurosciences.”

With the aging population and prevalence of obesity in the United States, the population of people who will need care for back pain will increase over the next several years, said Mr. Nolan, and creating a true neurosurgery and spine center of excellence will make your hospital a destination for those patients. The program should include clinical, research and lab components. Additional factors critical to success include:

1. Shared vision and incentives.
There should be a well-defined vision of the future that is easily articulated among all constituents. Senior leadership should develop a program-specific plan and support it throughout the department. Physicians, administrators and clinical staff must work together toward the same long term goals and there should be alignment of incentives and strategic planning goals within the program’s future vision.

2. Margin and capital.
There must be a strong financial performance with programs that are able to fund capital expansion. You need grant-funded programs and ongoing philanthropic support. Prioritize the program at the system level such as many hospitals have done for cardiac, cancer and women’s services.

3. Organization, leadership and involvement.
There must be dedicated clinical and administrative leadership with strong collaborative efforts among clinicians and researchers. The governance structure should encourage broad-based participation and autonomous decision-making. There should be program-specific management reports detaining the economics and clinical performance of the program.

4. Market opportunity.
The program should be a market leader in most or all disciplines and draw significant numbers of patients from outside traditional service areas. There should be low out-migration from service areas for neurosurgery and spine-related services.

5. Medical staff.
The medical staff should have a subspecialty interest and expertise in a wide range of disciplines and there must be physician champions driving the project. You want nationally recognized clinicians to support your program. Create a spirit of multi-disciplinary collaboration among all disciplines and recruit physicians in the right specialties.

6. Clinical programs.
Build a well-coordinated continuum of care by defining interdisciplinary programs. Make sure you have dedicated clinical nurse specialists and a strong referral relationship with the hospital system and the community. The physicians should understand and have interest in maintaining these relationships with referral sources.

7. Research and education.
Research and education should be an integral part of the day-to-day clinical activities. The research should include basic science, traditional and clinical projects as well as outcomes research with and without funding. Also consider how the residents and fellows fit into the research.

8. Superior workshop.
Have a dedicated inpatient and outpatient space co-located and convenient for patients. Make an investment in the latest technology and a strong clinical support staff. The department should also have sufficient operating room space and inpatient beds to serve your population.

9. Customer focus.
Your department should be a one-stop shop destination for neurosurgery patients with high accessibility and low wait times for patients. You want a transparent referral process and an aesthetically pleasing facility to attract patients. Also include patient support groups and differentiate outcomes using publically available data.

10. Imaging and marketing.
Achieve national recognition and destination capability for marketing the facility. Hold symposia to gather the nation’s leading experts and update your website to include the next level of web capabilities. Move down the road to a more interactive website and focus one where you have the opportunity to expand into new territory.

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