4 Best Practices for Staffing Hospital-Based Spine Programs

Chicago-based NeuStrategy and San Diego-based SpineMark recently completed a nationwide survey of hospital-based spine programs to determine best practices of leading spine programs.


The Spine COE® (Center of Excellence) Survey evaluated the infrastructure of four critical components — programs, staff, facility/technology and business — of 99 spine care programs across 35 U.S. states and three international locations. The survey segments participating hospitals into two categories: emerging versus comprehensive programs, with comprehensive programs leading the way in spine care.

The results of the survey shed light on some of the best practices being employed at leading spine programs across the country. Marcy Rogers, president and CEO of SpineMark, a spine center development firm, shares the following four best practices for staffing at spine programs as indicated by the survey.

1. Establish interdisciplinary, collaborative spine care teams. The largest difference between newly established and comprehensive spine programs in regards to staffing is the use of the interdisciplinary collaborative patient care teams. These teams allow for coordinated care through previously established patient care pathways — another best practice of spine centers of excellence in regards to programming.

"Spine care is so fragmented that it is important to get patients into the correct care pathway right out of the gate and then involve various providers in coordinated care along each patient's pathway," says Ms. Rogers.

Comprehensive spine program care teams often include neurosurgeons, orthopedic surgeons, physiatrists, neurologists and interventional neuroradiologists. Successful patient care teams serve a variety of functions, such as conducting weekly patient care conferences and monthly case reviews, reviewing and selecting implant vendors, determining performance indicators and planning spine program pathways.

2. Involve allied professionals in spine care teams. The highest regarded spine programs are also more likely to involve allied professionals directly involved in spine care by making them part of patient spine care teams. For example, comprehensive spine programs are significantly more likely to employ a dedicated physical therapist, physician assistant or nurse practitioner.  

Successful spine programs must also ensure that staffing in other departments directly affecting the spine program is adequate for treating all the spine program's patients. Ms. Rogers warns that radiology departments are sometimes under-staffed or ill-equipped to meet the needs of the volume of additional patients brought to the hospital by the spine program. "Make sure to run a simulation of patient flow of pain patients through all relevant departments, such as radiology or the OR" says Ms. Rogers. "Throughput can get clogged up quickly from increased volumes if you don't have adequate coverage in all relevant areas, which reduces the efficiency of your program and may affect a patient's experience."

3. Utilize nurse navigators. Another practice that sets the top spine programs apart from other programs is the use of nurse navigators to guide patients through their care pathways, says Ms. Rogers.

"After a patient is triaged and placed in a care pathway, the nurse navigator takes over. The nurse functions like a traffic director to keep the patients on their pathway and coordinates scheduling and treatments between various departments within the spine program, such as pain management, radiology and surgery," she says.

4. Consider offering complementary medicine. Finally, spine programs that wish to expand their services may want to consider offering complementary or alternative services, such as acupuncture, massage therapy or reflexology. Comprehensive spine programs are nearly three times as likely as emerging programs to have a chiropractor on staff and are five times more likely to offer acupuncture, according to the survey. These complementary service lines can also improve spine program revenue

Learn more about the Spine COE® Survey.

Read four best practices for hospital spine center programming unveiled by the Spine COE® Survey.

Note: "COE" is a registered trademark of NeuStrategy, Inc.

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