Spinal cord injuries: overcoming barriers to seamless care for patients

Abstract

Patients with spinal cord injuries (SCIs) often have complex needs that require multidisciplinary support in specialist centres. Optimal management depends on seamless transitions between service providers. Delays at any point potentially compromise clinical outcomes and efficient resource utilisation. The Spinal Advisory Working Group aims to develop and implement practical initiatives to improve SCI care, initially focusing on admission and discharge. A literature review identified few relevant papers. In addition, the generalisability of the findings of these papers to SCI centres in the UK is unclear. Therefore, further research is needed to, for example: establish best practice in the UK; quantify the associations between admission criteria and clinical and economic outcomes from a UK perspective; and determine the extent and impact of barriers that influence the transition of SCI patients between NHS care providers. Such research would enable the development of evidence-based strategies to overcome or minimise these barriers. In the meantime, pragmatic consensus guidelines would help standardise management, aid service optimisation, overcome inequities and, potentially, reduce bed blocking. The working group agreed that the robust inclusion and exclusion criteria developed by the Welsh Spinal Cord Injury Rehabilitation Centre could form the basis of a consensus guideline, to be piloted across the five SCI centres represented by members of the group.

How Can Policymakers be Encouraged to Support People With Spinal Cord Injury—Scoping Review

“…Any delay in management leads to multiple complex and costly consequences. 24 Appropriate and timely medical care, proper rehabilitation services, and social support can lead to better outcomes and a productive life for individuals with SCI as well as their families. Action by governments and other institutions is necessary.…”

Talking about post‐injury sexual functioning: The views of people with spinal cord injuries—A qualitative interview study

“…The World Health Organization (2013) defined spinal cord injury (SCI) as damage to the spinal cord resulting from trauma, disease or degeneration. The annual global incidence of SCI has been estimated at between 250 000 and 500 000, of which approximately 55% are traumatic (Donovan et al, 2017). It is estimated that 50 000 people are living with SCI in the United Kingdom (Spinal Injuries Association, 2020).…”

“…Individuals are faced with devastating loss and an abundance of new information that can cause extreme stress and anxiety (Hess & Hough, 2012). Literature suggests that concerns associated with sexual functioning are poorly handled during the rehabilitation phase of the patient's journey (Donovan et al, 2017), and although sexual functioning is an important aspect of holistic care (Bodner, 2011), it is not routinely (Gianotten et al, 2006) nor adequately (Evans, 2013; New & Currie, 2016) addressed in health‐care settings.…”