What Is the Pathway to the Best Model of Care for Traumatic Spinal Cord Injury? Evidence-Based Guidance

Top Spinal Cord Inj Rehabil, 2023 · DOI: 10.46292/sci23-00059S · Published: January 1, 2023

Spinal Cord Injury Healthcare Rehabilitation

Simple Explanation

People with traumatic spinal cord injury (tSCI) experience lifelong physical and emotional health impacts, needing specialized care that is complex to navigate. The non-standardized care pathways used by different jurisdictions to address these needs lead to care inequities and poor health outcomes. This is the first comprehensive care pathway for tSCI. The Pathway is grounded in person-centred care, integrated care and services, and up-to-date clinical practice guidelines.

Study Duration

Not specified

Participants

Eighty key partners engaged in planning, providing, and receiving tSCI care

Evidence Level

Not specified

Key Findings

1
The tSCI Pathway was drafted in overarching and detailed formats.
2
Team-based primary care and navigation supports were seen as crucial to reduce inequities.
3
Seventy-one quality indicators were developed that map onto all stages of the care pathway to measure system performance.

Research Summary

This is the first comprehensive care pathway for tSCI in Canada and one of the most detailed worldwide. The tSCI Care Pathway fills a gap in guidance by providing clarity on what care and services are needed from time of injury to life in the community and mitigates the causes of inequitable care provision and compromised health outcomes. The Pathway is inclusive to all, independent of location of residence, income, or population group; it is adaptable to varied models of care; and it covers elements from time of injury to needs across the lifespan.

Practical Implications

Healthcare Planning

Policymakers and administrators can use the tSCI Care Pathways and associated quality indicators to plan healthcare priorities, design and evaluate healthcare systems, and allocate funds.

Clinical Practice

Clinicians and community care and service providers can take advantage of the linkage with clinical practice guidelines.

Patient Outcomes

Persons with lived experience and their families benefit from a better understanding of the injury, next steps, expectations, needed education, and available supports across the lifespan, with the overall goal of improving health outcomes, self-management, and community participation for all.

Study Limitations

1
The initial care pathway targeted traumatic injuries, and future work will include nontraumatic injuries.
2
Clinical consensus and lived experiences from one province were used, potentially limiting generalizability.
3
Adaptation may be needed for different cultural and socioeconomic settings.

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