title: Spinal cord injuries: overcoming barriers to seamless care for patients.
abstract: Patients with spinal cord injuries (SCIs) often have complex needs that require multidisciplinary support in specialist centres. Optimal management depends on seamless transitions between service providers. Delays at any point potentially compromise clinical outcomes and efficient resource utilisation. The Spinal Advisory Working Group aims to develop and implement practical initiatives to improve SCI care, initially focusing on admission and discharge. A literature review identified few relevant papers. In addition, the generalisability of the findings of these papers to SCI centres in the UK is unclear. Therefore, further research is needed to, for example: establish best practice in the UK; quantify the associations between admission criteria and clinical and economic outcomes from a UK perspective; and determine the extent and impact of barriers that influence the transition of SCI patients between NHS care providers. Such research would enable the development of evidence-based strategies to overcome or minimise these barriers. In the meantime, pragmatic consensus guidelines would help standardise management, aid service optimisation, overcome inequities and, potentially, reduce bed blocking. The working group agreed that the robust inclusion and exclusion criteria developed by the Welsh Spinal Cord Injury Rehabilitation Centre could form the basis of a consensus guideline, to be piloted across the five SCI centres represented by members of the group.
authors.affiliation: Senior Nurse for Neurosciences and ALAC, Cardiff and Vale UHB.
authors.forename: Lorraine
authors.initials: L
authors.lastname: Donovan
authors.affiliation: Spinal Specialist Nurse, North West Regional Spinal Injuries Centre, Southport.
authors.forename: Lee
authors.initials: L
authors.lastname: Francis
authors.affiliation: Clinical Nurse Specialist, Princes Royal Spinal Cord Injuries Centre, Sheffield Teaching Hospitals.
authors.forename: Paula
authors.initials: P
authors.lastname: Muter
authors.affiliation: Ward Manager, Musgrave Park Hospital, Belfast Health and Social Care Trust, NI.
authors.forename: Sheila
authors.initials: S
authors.lastname: Nevin
authors.affiliation: Nurse, Ward Manager, Midland Centre for Spinal Injuries, Oswestry.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Warren
mesh_terms: D001315:Australia; D032921:Consensus; D003266:Continuity of Patient Care / Q000592:standards*; D006291:Health Policy; D006801:Humans; D010360:Patient Transfer / Q000592:standards*; D017410:Practice Guidelines as Topic; D058996:Quality Improvement; D013119:Spinal Cord Injuries / Q000534:rehabilitation*; D006113:United Kingdom; D014852:Wales
keywords: Patient admission; Patient discharge; Patient transfer; Rehabilitation centres; Spinal cord injuries