Defining spine care: a framework for scope, standards, and bidirectional care transitions

Area of Science:

• Spine Surgery
• Healthcare Management
• Clinical Pathways

Background:

• Modern spine care is fragmented, leading to inconsistent terminology, variable standards, and inefficient patient referrals.
• These issues result in duplicated services, delayed or premature escalation of care, and prolonged low-value treatment episodes.

Purpose of the Study:

• To present an implementation-oriented conceptual framework to enhance transition reliability across the spine-care continuum.
• To address fragmentation and improve coordination in multidisciplinary spine care.

Main Methods:

• A narrative synthesis of multisociety position statements, guideline standards, value-based literature, and clinical policy analyses.
• Development of a four-element framework focusing on roles, handoff triggers, standardized language, and boundary-zone interventions.

Main Results:

• The proposed framework includes defined roles and accountability, explicit bidirectional handoff triggers, standardized procedural language, and coordinated management of complex interventions.
• Implementation aims to reduce care drift, enhance safety and consistency, and support timely escalation and de-escalation.

Conclusions:

• Standardizing terminology, clarifying accountability, and operationalizing bidirectional transitions are key to improving multidisciplinary spine care.
• The framework offers a practical approach to enhance coordination, patient navigation, and overall value in spine care.