Right care, right time, right place: improving outcomes for people with spinal cord injury through early access to intervention and improved access to specialised care: study protocol

BMC Health Services Research, 2014 · DOI: 10.1186/s12913-014-0600-7 · Published: November 12, 2014

Simple Explanation

Traumatic spinal cord injury (TSCI) is a devastating condition that significantly impacts a person's health, well-being, and independence. This study aims to understand the journey of patients with TSCI from the time of injury to specialized care. The study will collect detailed data from the point of injury through acute care, rehabilitation, hospital discharge, and community reintegration. Follow-up telephone interviews will be conducted at 6, 12, and 24 months post-injury. The goal is to identify factors that affect patient flow, resource utilization, costs, and quality of life for both patients and their families. The research seeks to pinpoint barriers and facilitators in early-care pathways to improve treatment outcomes.

Study Duration

2 years

Participants

Approximately 300 patients aged 16 years and older with traumatic spinal cord injury

Evidence Level

Not specified

Key Findings

1
Delays in reaching specialist care increase the occurrence of complications such as pressure injuries and urinary tract infections.
2
Early admission to a SCIU has demonstrated reduced hospital length of stay by 30%, a three-fold reduction in the rate of pressure ulcers and reduced DVT incidence.
3
The study aims to determine the proportion of cases that comply with the recommended maximum of 24 hours from injury to commencement of specialist care in SCIU.

Research Summary

This study aims to describe the clinical journey of people with traumatic spinal cord injury (TSCI) from injury to definitive diagnosis and specialized treatment, and to assess a range of outcomes up to 24 months post-injury. The research will quantify associations between the clinical journey and patient outcomes, identifying factors related to health outcomes, well-being, and access to specialist SCIU care. By overlaying patient flow data with health service infrastructure details, the study will analyze the quality, sufficiency, and efficiency of healthcare delivery for TSCI patients in NSW and Victoria.

Practical Implications

Improved Clinical Pathways

Identifying factors that cause delays in accessing specialized care can lead to the development of streamlined and more effective clinical pathways for TSCI patients.

Resource Allocation

Understanding the impact of timely access to SCIUs can inform resource allocation decisions to ensure that appropriate facilities and staff are available.

Policy Development

The study findings can be used to develop and refine policies related to the management of TSCI, including triage, transport, and inter-hospital transfer protocols.

Study Limitations

1
The study is limited to two Australian states, which may not be representative of other regions or countries.
2
Reliance on medical record data and telephone interviews may introduce biases related to data accuracy and recall.
3
The observational nature of the study limits the ability to establish causal relationships between specific interventions and patient outcomes.

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