Quality and Safety Improvement in Spine Surgery

Abstract

Study Design: Review article. Objectives: A narrative review of the literature on the current advances and limitations in quality and safety improvement initiatives in spine surgery. Methods: A comprehensive literature search was performed using Ovid MEDLINE focusing on 3 preidentified concepts: (1) quality and safety improvement, (2) reporting of outcomes and adverse events, and (3) prediction model and practice guidelines. The search was conducted under appropriate subject headings and using relevant text words. Articles were screened, and manuscripts relevant to this discussion were included in the narrative review. Results: Quality and safety improvement remains a major research focus attracting investigators from the global spine community. Multiple databases and registries have been developed for the purpose of generating data and monitoring the progress of quality and safety improvement initiatives. The development of various prediction models and clinical practice guidelines has helped shape the care of spine patients in the modern era. With the reported success of exemplary programs initiated by the Northwestern and Seattle Spine Team, other quality and safety improvement initiatives are anticipated to follow. However, despite these advancements, the reporting metrics for outcomes and adverse events remain heterogeneous in the literature. Conclusion: Constant surveillance and continuous improvement of the quality and safety of spine treatments is imperative in modern health care. Although great advancement has been made, issues with reporting outcomes and adverse events persist, and improvement in this regard is certainly needed.

The language of all medical publications and spine publications from 1950 to 2020

“…and Hines et al. focused on quality improvement in the field of spinal surgery [ 14 , 15 ]. Jiang et al.…”

“…suggest that reporting of outcomes has remained inconsistent within the field, while Hines et al. note that the use of registries will help deliver patient centered, efficacious care [ 14 , 15 ]. Reporting outcomes across all languages to such registries will create massive databases that physicians will then be able to access and further evaluate how certain treatments will affect their patients.…”

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“…Spine surgery has seen a rapid advancement in recent years due to novel technological innovations, safety improvements, and increased understanding of the pathophysiology of spinal conditions ( 10 ). With the rising number of annual spinal procedures performed worldwide, the associated growing costs are becoming a major health economic burden ( 11 ).…”

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“…Most surgeries are performed adequately on reasonable clinical candidates by experienced surgeons. 53 Despite technological advances, our ability to fully diagnose all pain generators for a specific patient is not complete. Similar to primary surgery, RSS should have informed consent detailing risks, benefits, and reasonable expectations regarding PROMs .…”