Improving access to emergent spinal care through knowledge translation: an ethnographic study

Area of Science:

• Spine Surgery
• Healthcare Management
• Qualitative Research

Background:

• Timely access to specialized care for emergent spinal conditions is critical for patient outcomes.
• Significant stressors exist for patients and families managing serious spinal conditions.
• Limited ethnographic research explores stakeholder perspectives on emergent spine care access.

Purpose of the Study:

• To identify challenges in providing timely emergent spinal care.
• To explore opportunities for enhancing emergent spine care delivery.
• To understand stakeholder views on emergent spine care access and provision.

Main Methods:

• An ethnographic study involving 21 interviews with administrative and clinical providers.
• Qualitative observations conducted in operating theatres, on an orthopaedic/neurosurgical ward, and at a provincial referral centre (CritiCall Ontario).
• Analysis of care pathways for patients referred through CritiCall Ontario for emergent spinal conditions.

Main Results:

• Key themes identified include inter-professional collaboration, hospital resources, and external organizational relationships.
• The complexity of emergent spine patients and the evidence base for care influence delivery.
• Implementation of knowledge translation strategies led to a reduction in out-of-province patient transfers.

Conclusions:

• Competing hospital and provincial priorities significantly challenge emergent spinal care delivery.
• Spinal care is recognized across multiple healthcare priorities, including emergent care and wait times.
• Despite new strategies, increasing referral trends necessitate ongoing inter-professional collaboration within institutional contexts.