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

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 ca...

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Published in:BMC health services research Vol. 22; no. 1; pp. 1565 - 10
Main Authors: Abedi, Aidin, Biering-Sørensen, Fin, Chhabra, Harvinder S., D’Andréa Greve, Julia Maria, Khan, Nasser M., Koskinen, Eerika, Kwan, Kenny Yat Hong, Liu, Nan, Middleton, James W., Moslavac, Sasa, Rahimi-Movaghar, Vafa, O’Connell, Colleen, Previnaire, Jean G., Patel, Alpesh, Scivoletto, Giorgio, Sharwood, Lisa N., Townson, Andrea, Urquhart, Susan, Vainionpää, Aki, Zaman, Atiq Uz, Noonan, Vanessa K., Cheng, Christiana L.
Format: Journal Article
Language:English
Published: London BioMed Central 21.12.2022
BioMed Central Ltd
Springer Nature B.V
BMC
Subjects:
Analysis
Care and treatment
Clinics
Data collection
Diagnosis
Evidence-based medicine
Health Administration
Health aspects
Health Informatics
Health surveys
Healthcare services
High-income countries
Humans
Income
Indicators
International
International survey
Low- and middle-income countries
Medicine
Medicine & Public Health
Methods
Nursing Research
Participation
Pilot Projects
Polls & surveys
Public Health
Questionnaires
Rehabilitation
Rehabilitation Centers
Services
Spinal cord injuries
Spinal Cord Injuries - rehabilitation
Surveys and Questionnaires
Trauma
Trauma centers
Traumatic spinal cord injury
Canada
Traumatic spinal cord injury
International survey
Healthcare services
Low- and middle-income countries
Indicators
High-income countries
ISSN:1472-6963, 1472-6963
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Summary: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.
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ISSN:1472-6963
1472-6963
DOI:10.1186/s12913-022-08847-w