دورية أكاديمية
A novel approach to expedite emergency investigation for suspected cauda equina syndrome referrals from community and primary care services: A service evaluation.
| العنوان: | A novel approach to expedite emergency investigation for suspected cauda equina syndrome referrals from community and primary care services: A service evaluation. |
|---|---|
| المؤلفون: | Gill J; Spinal Surgery Service, Somerset NHS Foundation Trust, Taunton, United Kingdom. Electronic address: Jonathon.gill@somersetft.nhs.uk., Greenhalgh S; Orthopaedic Interface Service, Bolton NHS Foundation Trust, Bolton, United Kingdom; Department of Health Professions, Faculty Health and Education, Manchester Metropolitan University, Manchester, United Kingdom., Latour JM; School of Nursing, Faculty of Health, University of Plymouth, Plymouth, United Kingdom; South West Clinical School, Somerset NHS Foundation Trust, Taunton, United Kingdom., Pickup S; Spinal Surgery Service, Somerset NHS Foundation Trust, Taunton, United Kingdom; Department of Health Professions, Faculty Health and Education, Manchester Metropolitan University, Manchester, United Kingdom., Yeowell G; Department of Health Professions, Faculty Health and Education, Manchester Metropolitan University, Manchester, United Kingdom. |
| المصدر: | Musculoskeletal science & practice [Musculoskelet Sci Pract] 2024 Aug; Vol. 72, pp. 102976. Date of Electronic Publication: 2024 May 14. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: Netherlands NLM ID: 101692753 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2468-7812 (Electronic) Linking ISSN: 24687812 NLM ISO Abbreviation: Musculoskelet Sci Pract Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Amsterdam : Elsevier, [2017]- |
| مواضيع طبية MeSH: | Cauda Equina Syndrome*/diagnosis , Referral and Consultation*/statistics & numerical data , Primary Health Care* , Magnetic Resonance Imaging*, Humans ; Retrospective Studies ; Male ; Female ; Middle Aged ; Adult ; England ; Emergency Service, Hospital ; Aged ; Community Health Services/methods |
| مستخلص: | Introduction: Although a rare spinal emergency, cauda equina syndrome (CES) can result in significant physical, emotional, and psychological sequalae. Introducing a CES pathway enhances diagnosis but may increase Radiology and Orthopaedic workload. To address this, one NHS hospital in England introduced a novel CES pathway. Utilising a criteria-led pathway, patients were referred directly from community/primary care, via the Emergency Department, for an emergency MRI scan. Objective: To compare the outcomes of patients referred via an original and redesigned Community and Primary Care CES pathway. Design: A retrospective service evaluation was undertaken of all emergency MRI scans investigating suspected CES via either pathway. Methods: Two 3-month time periods were analysed; pre-(original) and post-implementation of the redesigned pathway; time to surgery was reviewed over two 12-month periods. Results: Increased MRI scan utilisation was seen following the implementation of the redesigned pathway: original n = 50, redesigned n = 128, increasing Radiology workload. However, the redesigned pathway resulted in a reduction in time to MRI from 3h:01m to 1h:02m; reduction in time spent in ED 4h:55m to 3h:24m; reduction in time to surgery 18h:05m to 13h:38m; reduction in out-of-hour scanning from 10 to 2 patients during the evaluation period; and a reduction in on-call Orthopaedic involvement by 38%. Conclusion: All timed outcomes were improved with the implementation of this novel pathway. This suggests expediting MRI scans can result in substantial downstream benefits; albeit while increasing MRI scan utilisation. This pathway aligns with the emergency management of suspected CES under the new national CES pathway in England. (Copyright © 2024 Elsevier Ltd. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Cauda equina syndrome; Clinical pathway; Red flags |
| تواريخ الأحداث: | Date Created: 20240520 Date Completed: 20240713 Latest Revision: 20240716 |
| رمز التحديث: | 20240717 |
| DOI: | 10.1016/j.msksp.2024.102976 |
| PMID: | 38768530 |
| قاعدة البيانات: | MEDLINE |
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