Author:
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.
Abstract
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.
Funder
Praxis Spinal Cord Institute
Health Canada
Western Economic Diversification Canada
Publisher
Springer Science and Business Media LLC
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