Examining collegiality in Saskatchewan - Saskatchewan Medical ...

Better patient-centered care for lower back pain
Streamlining improves treatment option for spine patients
By Carolyn Hamilton, Saskatchewan Health
Saskatchewan is introducing a new way
to assess and treat patients with lower
back pain that will provide them with
rapid, consistent, patient-centred care.
Primary health care providers such as
family physicians, chiropractors and
physiotherapists can now take an online
continuing education course on
handling lower back injuries, made
available through the Saskatchewan
Surgical Initiative’s spine pathway.
Dr. Daryl Fourney, Dr. Hamilton Hall,
and Dr. Joseph Buwembo, physician
instructors in the Saskatchewan Spine
Pathway online CME program.
Photo credit: Kiriako Iatridis
‘Patient pathways’ are recognized as an
innovative way to streamline care for
patients as they move through the system,
and ensure they quickly receive
the most appropriate treatment. They
have been shown to reduce time for assessment,
improve patient outcomes,
shorten hospital stays, and provide
more consistent clinical practice. The
continuing education course is Phase
One of the Saskatchewan Spine Pathway;
Phase Two will involve providing
spine clinics at multi-disciplinary clinics
in Saskatoon and Regina.
“Patients with spinal disorders often
wait too long for access to specialists,
diagnostic tests and surgery,” Health
Minister Don McMorris said. “This
spine pathway will result in improved,
streamlined processes that quickly direct
patients to the most appropriate
treatment and care that is co-ordinated
among multiple health care providers.
It is another step toward sooner, safer,
smarter care for patients.”
The spine course gives primary care
providers a simple, accurate system
to determine whether a patient’s back
pain can be resolved with simple exercises
and rest, or whether they need an
MRI or a surgical referral.
“Every year, approximately 10 per cent
of Saskatchewan residents will experience
a back strain or injury,” Regina
neurosurgeon Dr. Joseph Buwembo said.
“The vast majority will get better in a
short time without medical care. About
10,000 will see a primary care provider
to manage their pain, which generally
resolves within six weeks without the
need for medical imaging. It can be challenging
for family physicians caring for
these patients, as there are a multitude
of different spine diagnoses. Which cases
will resolve on their own? Which will
require a referral to a spine surgeon?
Which cases are likely to develop into
chronic pain? To answer these challenging
questions, an expert panel of health
providers was assembled. Over a three-
TECHNOLOGY
year period they developed a simple,
consistent process to assess and manage
lower back pain.”
“There is certainly a problem with
the current system when referrals to
overburdened surgeons consist of patients
who are ‘inappropriate’ for surgery,”
Saskatoon neurosurgeon Dr. Daryl
Fourney said. “These patients may
not need surgery, but they need access
to care that is timely, effective and
evidence-based. The goal of the Saskatchewan
Spine Pathway is not only
to improve access to the spine surgeon
for patients who are likely to be surgical
candidates, but also to enhance patient
and referral physician education
so that consistent information is provided
and effective non-surgical therapies
can be initiated earlier. It requires
physicians to classify symptoms based
on five distinct pain patterns that can
be easily determined by history and
physical examination.”
The Saskatchewan Spine Pathway is
one of the initiatives underway as part
of the Saskatchewan Surgical Initiative,
which is focused on improving the surgical
patient experience and reducing
surgical wait times to no more than
three months by 2014. More information
about the online course is available
at www.spinepathwaysk.ca.
For more information about the program,
contact Gwendolyn Friedrich with Saskatchewan
Health at (306) 787-3656 or by
email at gfriedrich@health.gov.sk.ca.
SMA News Digest Spring 2011 13