Published: March 2023. Next review: 2027.
A spinal cord injury is a serious and complex injury that requires access to highly specialised services.
This pilot model of care recommends a way to improve access to specialist care and outcomes for people with spinal cord injury in NSW. It also aims to build workforce capability in non-specialist hospitals.
Key components to the pilot:
- Early identification of patients requiring access to specialist units.
- Testing the model to support the delivery of care and capability building at spoke sites.
Guiding principles:
- Equity of access
- Timely surgery
- Care coordination across referral networks
- Person-centred care plans
- Early discharge planning to facilitate seamless transition to community
- Effective community reintegration
- Quality improvement via data collection and education
- Benchmarking with standardised functional measures.
At a glance
The Spinal Cord Injury Pilot Model of Care uses a hub and spoke model to ensure people with a spinal cord injury will receive care in:
- a specialist spinal unit (hub site) for people with highly complex injury; or
- a non-specialist hospital (spoke site) supported by access to multidisciplinary specialists via a hybrid shared care model, for people with less complex care requirements.
Benefits of the model:
- Addresses bed-block in specialist units and acute care facilities.
- Shortens length of stay and reduces complications and readmissions.
- Reduces clinical variation in the provision of care.
- Provides access to multidisciplinary specialist care for patients in spoke sites.
Developing the model of care
A dynamic simulation (computer-based) model was created to simulate the model of care under different resource conditions. The aim was to assess its impact on access to specialist care.
The outcomes have informed the clinical pathways outlined in the pilot model of care.
Download the dynamic simulation modelling report (PDF 966.9 KB)
Background
Spinal cord injury refers to persistent damage to neural tissue and disruption of transmission along the nerves. It has a profound effect on a person’s health, function, participation in daily activities and quality of life. It marks the start of an ongoing relationship between a patient and the healthcare system.
Care for a person with a spinal cord injury occurs across acute, rehabilitation and community settings. Patients often have multiple hospitalisations in a year.
There is an identified need for more specialist and specialist-guided services for people with spinal cord injury in NSW.
This document refers to a conceptual future-focused model of care for spinal cord injury. It has not been funded for implementation.