title: Nurse practitioner-led surgical spine consultation clinic.
abstract: OBJECTIVE
  This study is a report of a study of patient satisfaction with non-surgical nurse practitioner management of pre-selected spinal referrals.
  
  
  BACKGROUND
  Nurse practitioners are linked to particular patient populations or specific physicians in a medical setting. In a universal healthcare delivery system, patients are often faced with long and anxiety-provoking waiting times, particularly for sub-specialized consultations such as spinal surgery.
  
  
  METHODS
  A nurse practitioner-led spine consultation ambulatory clinic was implemented at a Canadian neuroscience centre. A prospective patient satisfaction and clinical accuracy study was performed in 2008. All patients assessed by the nurse practitioner completed a post-consultation validated patient satisfaction questionnaire. All patients were reviewed with the surgeon for confirmation of diagnosis and management.
  
  
  RESULTS
  A total of 177 pre-selected patients (disc-herniations, spinal stenosis, degenerative disc disease) were assessed by the nurse practitioner. Mean time from referral to nurse practitioner clinic assessment was 12 weeks (range: 9·8-21 weeks) compared with 10-52 weeks if seen in a conventional clinic. Nurse practitioner clinical diagnosis and management plan were in agreement with those of the surgeon (100% and 95% respectively). Patient satisfaction was 97% with the consultation and 94% and with examination thoroughness. Preference for a longer waiting period for direct consultation with the surgeon was 26%.
  
  
  CONCLUSIONS
  Nurse practitioners can play an effective and efficient role in providing care to patients requiring specific disease management in a specialty setting. The nurse practitioner-run clinic offers accurate and earlier assessment, thus facilitating a timelier diagnosis and management plan.
authors.affiliation: Spine Toronto Western Hospital, Ontario, Canada. angela.sarro@uhn.on.ca
authors.forename: Angela
authors.initials: A
authors.lastname: Sarro
authors.forename: Yoga Raja
authors.initials: YR
authors.lastname: Rampersaud
authors.forename: Stephen
authors.initials: S
authors.lastname: Lewis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000458:organization & administration; D002170:Canada; D002983:Clinical Competence / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009722:Nurse Practitioners; D024802:Nurse's Role; D009730:Nursing Assessment / Q000592:standards; D017060:Patient Satisfaction; D057184:Practice Patterns, Nurses' / Q000458:organization & administration*; D012017:Referral and Consultation / Q000458:organization & administration*; D057566:Self Report; D013122:Spinal Diseases / Q000451:nursing*; D013997:Time Factors; D055815:Young Adult