Institution-Based Quality and Safety Improvement Initiatives in Spine Surgery: A Scoping Review

Area of Science:

• Healthcare Management
• Surgical Quality Improvement
• Patient Safety Research

Background:

• Value-based healthcare necessitates advancements in patient safety and quality.
• Spine surgery is a complex, multidisciplinary field requiring coordinated efforts.
• This review maps research on establishing and implementing institution-based quality improvement (QI) in spine surgery.

Purpose of the Study:

• To conduct a scoping review of research on quality improvement (QI) initiatives in spine surgery.
• To identify the establishment, implementation, impacts, barriers, and facilitators of QI in this surgical domain.

Main Methods:

• Systematic electronic searches of PubMed, Web of Science, and Scopus databases.
• Inclusion of qualitative or quantitative studies detailing QI program implementation in spine surgery.
• Data extraction and quality assessment using Standards for Quality Improvement Reporting Excellence (SQUIRE) guidelines.

Main Results:

• 133 records were included, with most addressing efficiency (88) and safety (74).
• Few studies utilized interventional trials (8) or multidisciplinary teams (67).
• Identified gaps include limited follow-up, small sample sizes, and inadequate outcome assessments.

Conclusions:

• QI initiatives in spine surgery demonstrate improvements in healthcare quality and patient safety.
• The long-term sustainability and generalizability of these QI initiatives remain largely unknown.
• Further research is needed to evaluate the sustained impact and broader applicability of QI in spine surgery.