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. Kevin Dunne, partner at NeuStrategy, shares four of these best practices focusing on programming.
1. Development of clinical pathways. One of the first differentiating factors between comprehensive and emerging programs is the use of clinical pathways to guide patient care. Comprehensive programs are at least half as likely and sometimes as much as three times as likely to follow clinical pathways, says Mr. Dunne. While helping to promote some level of standardization and evidence-based medicine, clinical pathways can be fundamental to shaping pre-treatment education needs, allowing patients to understand what will occur from one step to the next during their treatment.
"We advocate for the development of clinical pathways within programs," says Mr. Dunne. "A pathway or standing order does not necessarily have to be the same for each practitioner within a program, but if the physicians can come to a consensus, that is helpful. It's more about guiding the staff in the delivery of patient care."
2. Outcomes tracking. Outcomes tracking is another best practice for spine centers of excellence. Outcomes tracking allows programs to evaluate the success of various treatments for various spinal conditions, and then use that data when selecting evidence-based treatments for patients. Comprehensive spine programs are significantly more likely to use an outcomes tracking mechanism than emerging programs. For example, 76 percent of comprehensive programs deploy some type of tracking mechanism for degenerative disc disease outcomes, while only 33 percent of emerging programs have that infrastructure in place, says Mr. Dunne.
While most spine programs only currently track and use outcomes data from within their own programs, the ultimate goal is for the widespread sharing of data by multiple programs. According to Mr. Dunne, a single national database to track spine outcomes has not yet been established. "A lot is being done on a program level, but you can only be so effective by comparing yourself to yourself. To benchmark across multiple programs is truly the goal," he says.
3. Participation in research. Another area that differentiates comprehensive from emerging spine programs is their involvement in research. According to Mr. Dunne, most spine programs focus their research efforts on device trials, which even small community-based programs can actively participate in through vendor relationships. "Participating in research does not mean the hospital has to be doing bench research or genetic-based work. Although this type of research is important, very few programs have the financial infrastructure to perform that type of research," he says.
Roughly half of comprehensive programs participate in device trials, while only one-fifth of emerging programs do, according to the survey. Spine programs that are actively involved in device trials are more likely to be able to offer access to innovative treatments that non-research programs may not yet be able to offer. Innovative treatment options attract patients to centers which not only benefit the patient but can benefit the center both financially and in terms of its reputation.
4. Offer the most-advanced techniques. Leading spine programs also offer access to the most-advanced techniques and procedures for treating the spine. As a result, comprehensive programs are more likely to provide access to minimally-invasive procedures. Minimally-invasive and other cutting-edge techniques allow the programs to treat the "toughest" cases, according to Mr. Dunne. "Comprehensive programs are more likely to have the infrastructure to deal with these more esoteric cases," he says.
Learn more about the Spine COE® Survey.
Note: "COE" is a registered trademark of NeuStrategy, Inc.
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. Kevin Dunne, partner at NeuStrategy, shares four of these best practices focusing on programming.
1. Development of clinical pathways. One of the first differentiating factors between comprehensive and emerging programs is the use of clinical pathways to guide patient care. Comprehensive programs are at least half as likely and sometimes as much as three times as likely to follow clinical pathways, says Mr. Dunne. While helping to promote some level of standardization and evidence-based medicine, clinical pathways can be fundamental to shaping pre-treatment education needs, allowing patients to understand what will occur from one step to the next during their treatment.
"We advocate for the development of clinical pathways within programs," says Mr. Dunne. "A pathway or standing order does not necessarily have to be the same for each practitioner within a program, but if the physicians can come to a consensus, that is helpful. It's more about guiding the staff in the delivery of patient care."
2. Outcomes tracking. Outcomes tracking is another best practice for spine centers of excellence. Outcomes tracking allows programs to evaluate the success of various treatments for various spinal conditions, and then use that data when selecting evidence-based treatments for patients. Comprehensive spine programs are significantly more likely to use an outcomes tracking mechanism than emerging programs. For example, 76 percent of comprehensive programs deploy some type of tracking mechanism for degenerative disc disease outcomes, while only 33 percent of emerging programs have that infrastructure in place, says Mr. Dunne.
While most spine programs only currently track and use outcomes data from within their own programs, the ultimate goal is for the widespread sharing of data by multiple programs. According to Mr. Dunne, a single national database to track spine outcomes has not yet been established. "A lot is being done on a program level, but you can only be so effective by comparing yourself to yourself. To benchmark across multiple programs is truly the goal," he says.
3. Participation in research. Another area that differentiates comprehensive from emerging spine programs is their involvement in research. According to Mr. Dunne, most spine programs focus their research efforts on device trials, which even small community-based programs can actively participate in through vendor relationships. "Participating in research does not mean the hospital has to be doing bench research or genetic-based work. Although this type of research is important, very few programs have the financial infrastructure to perform that type of research," he says.
Roughly half of comprehensive programs participate in device trials, while only one-fifth of emerging programs do, according to the survey. Spine programs that are actively involved in device trials are more likely to be able to offer access to innovative treatments that non-research programs may not yet be able to offer. Innovative treatment options attract patients to centers which not only benefit the patient but can benefit the center both financially and in terms of its reputation.
4. Offer the most-advanced techniques. Leading spine programs also offer access to the most-advanced techniques and procedures for treating the spine. As a result, comprehensive programs are more likely to provide access to minimally-invasive procedures. Minimally-invasive and other cutting-edge techniques allow the programs to treat the "toughest" cases, according to Mr. Dunne. "Comprehensive programs are more likely to have the infrastructure to deal with these more esoteric cases," he says.
Learn more about the Spine COE® Survey.
Note: "COE" is a registered trademark of NeuStrategy, Inc.