Improving Care of Patients with Back and Neck Pain

Overview

Initiative type

Model of Care

Status

Deliver

Published

11 September 2017

Topic

Integrated care Model of care Musculoskeletal

Summary

This initiative improves the referral process by establishing a single point of entry for all back pain patients. A single screening and triage hub will review all new referrals and those waiting to see a specialist. It will be staffed by a General Practitioner with Special Interest (GPwSI) in back pain and a senior allied health professional. They will aim to connect patients to appropriate services as rapidly as possible, form alliances and improve communication between healthcare professionals. There will also be substantial education components to empower patients and primary care providers to manage and treat back pain.

Key dates

Jan 2016 - Mar 2019

Implementation sites

Metro North Hospital and Health Service

Partnerships

Healthcare Improvement Unit, Brisbane North PHN

Aim

The aim of the MNHHS Back and Neck Pain Pathway project was to deliver a patient centred back pain service that focuses on; coordinated care, improved access to services, timely treatment, the right level of care for patients and tailored education for patients and care providers.

Benefits

Coordinated care
Improved access to services
Timely treatment
The right level of care for patients
Tailored education for patients and care providers.

Background

Back pain is the worldwide leading cause of disability. One in six Australians suffer with back pain which greatly impacts on the individual’s quality of life and has wide spread economic impact. This equates to 100,000 MNHHS adult residents and around 28,000 residents over 65 years of age affected by significant back pain. The cost of treating back pain in Australia is approximately $5 billion every year.

The Integrated Care Innovation Fund provides financial support to innovative projects that deliver better integration of care, address fragmentation in services and provide high-value healthcare. Funded projects also demonstrate a willingness to embrace and encourage the uptake of new technology alongside the benefits of integrating care and improving communication between health care sectors.

Solutions implemented

Project initiatives were delivered through the development, implementation and establishment of the Healthy Spine Service. The Healthy Spine Service consists of;

Spinal Health Hub: A single point of entry hub for all back and neck pain referrals received into MNHHS. Referrals are categorised in accordance with the CPC and streamed to the most appropriate MNHHS facility and department by the GPwSI.
Healthy Spine Clinic: GPwSI led clinic providing rapid access and early intervention for category 2 and category 3 patients with back and neck pain. The clinic operates from the Northwest Community Health Centre (CHC) with the aim of initiating a change in the patient’s expectation of surgical intervention and hospital based healthcare.
Healthy Spine Program: An education program delivered to patients with a focus on positive health attitudes. Providing support and information for patients to empower them to proactively self-manage their condition.

Evaluation and results

A comprehensive evaluation will be provided by AusHSI no later than December 2018. Earlier than expected outcomes have been realised through the implementation of the Healthy Spine Service.

The Healthy Spine Service provides value based healthcare for patients and capacity release for MNHHS secondary care facilities.
The Spinal Health Hub has also demonstrated an improvement in the quality of referrals and information received through collaboration with primary and community care providers’ ensuring all essential clinical information is included thereby reducing the time it takes to categorise referrals.
As the Spinal Health Hub is applying the Clinical Prioritisation Criteria (CPC) there is consistency in referral acceptance and categorisation. This is providing equitable access for patients, based on clinical urgency and ensuring that patients are ready for care at their first specialist appointment.
The Spinal Health Hub is streaming referrals directly to alternative pathways that are equipped to manage complex back or neck pain. This is reducing unnecessary patient movement around the HHS and providing patients with the right level of health care the first time.
The Healthy Spine Service also aligns to the state-wide Closer to Home strategy in treating patients within their local area.

Lessons learnt

To enable change to occur the project team throughout the project operated with the following core values:

Respect – all stakeholders were invited to participate and all feedback was given thoughtful consideration
Transparency – honest and forthcoming communication from the project team to stakeholders, especially in relation to data and audit results
Accountability – The project team and stakeholders are equally held accountable for a standard of performance by the governing Steering Committee
Consistency – The project team provided consistent messages and communication to stakeholders

References

Foster, E, N. et le (2018) low back pain 2. The Lancet pg. 1 – 16.

Hartvigen, J., et el (2018) What low back pain is and why we need to pay attention. The Lancet pg. 1 –12.

Buchbinder, R. et el (2018) Low back pain: a call for action. The lancet pg. 1 – 5.

Key contact

Louise Endicott

Principal Project Officer