Building and Sustaining Inpatient-Clinician Collaboration in Spinal Cord Injury Rehabilitation: A Case Example Using the Stoke Mandeville Spinal Needs Assessment Checklist (SMS-NAC) and Goal Planning Programme

Abstract

Goal planning is core for the delivery of the biopsychosocial model of rehabilitation and is commonly practiced in spinal cord injury (SCI) and other physical health settings. Despite a strong theoretical basis from several branches of psychology, evidence regarding specific practice, interventions and impact has yet to be established, with no universal standards in this area. Study One outlines the standards used at the National Spinal Injuries Centre (NSIC), Stoke Mandeville Hospital since the inception of the SMS-NAC and goal planning programme in 1989. The results outline the impact of a quality improvement project undertaken since 2016 and track the interventions used to improve inpatient care. Study Two reports on an international survey of rehabilitation measure usage and goal planning practice with inpatient adult and children and young people (CYP) with SCI. Respondents replied that inpatient presence at goal planning meetings only took place in 75% (adult) and 76% (CYP) of services, with more services indicating 4 or more members of the multidisciplinary team being present (85% and 90%, respectively). This paper demonstrates the gains that can be made when a structured quality improvement methodology is used and highlights the need for standards regarding goal planning in SCI rehabilitation to be developed.

Sexual activity (re-)engagement following spinal cord injury: Identifying behavior change targets for intervention development.

“…From a patient/partner-HCP perspective, setting and reviewing regular goals with appropriate HCPs, built in with reward-based incentives felt to be a beneficial approach to aid encouragement, structure, and motivation in supporting with sexual (re-)engagement. Indeed, wider research has shown that need assessment and goal planning frameworks enhance the efficacy and individual tailoring of SCI rehabilitation (Duff et al, 2022). Goals can also be used to evaluate the effectiveness of rehabilitation interventions (Wade, 2009), which may enable a future post-SCI sexual well-being intervention to be closely monitored in terms of individual goal attainment.…”

Care needs of adults with spinal trauma in the prehospital and hospital setting from the perspective of patient care team: A qualitative research

“…To provide basic care for the patients with definitive spinal cord injury or at risk of it in the prehospital and hospital stage, extensive research needs to be conducted in this regard. It should be noted that previous studies have mainly focused on rehabilitation needs and planning for its improvement[ 14 18 19 20 ] and assessment of psycho-social[ 21 22 23 ] and sexual needs. [ 14 24 25 ] Moreover, these needs have generally been assessed from the perspective of the patients and families,[ 14 18 19 20 21 22 23 24 25 ] and the care needs of these patients in the acute and emergency phase and from the perspective of care providers have been neglected.…”

“…It should be noted that previous studies have mainly focused on rehabilitation needs and planning for its improvement[ 14 18 19 20 ] and assessment of psycho-social[ 21 22 23 ] and sexual needs. [ 14 24 25 ] Moreover, these needs have generally been assessed from the perspective of the patients and families,[ 14 18 19 20 21 22 23 24 25 ] and the care needs of these patients in the acute and emergency phase and from the perspective of care providers have been neglected. Thus, the aim of this study was to explain the care needs of adult patients with spinal cord injury in the prehospital and hospital stages from the perspective of the patient care team.…”