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Table 2 Percent of acute facilities by country income level meeting each indicator

From: An international survey of the structure and process of care for traumatic spinal cord injury in acute and rehabilitation facilities: lessons learned from a pilot study

Indicators

HIC

N = 13

LMIC

N = 13

Specialized care

 Classify tSCI with neurological examination (p)

77

62

 Have a team of clinical staff with SCI expertise (s)

85

46

 Have a multidisciplinary team (s)

85

38

Timeliness & transition

 Have a triage protocol for direct admission (p)

69

31

 Have a direct relationship between acute SCI unit and referring rehab centers (s)

85

69

 Have rehab facilities in acute unit (s)

92

54

 Have spine surgeon on-call 24 h (s)

92

85

 Have 24 h access to MRI (s)

100

62

 Provide SCI medical follow-up (p)

100

92

 Have 24 h access to CT scanner (s)

100

100

 Have 24 h access to operating room (s)

100

100

 Provide early rehab in acute setting (p)

100

100

Patient-centeredness

 Have a peer counsellor (s)

54

23

 Have a psychologist (s)

85

62

 Provide services for detection and treatment for mental health (p)

100

62

Capacity to advance evidence-based care

 Make regular use of data to inform SCI care (p)

54

46

 Practice of care standardized to recommendations/guidelines (p)

69

38

  1. Structure and process indicators are represented by (s) and (p), respectively. Italic represents “hard to meet” indicators. HIC High-income countries, LMIC Low- and middle-income countries, SCI Spinal cord injury, tSCI Traumatic SCI. All the indicators, except for those listed below, were a yes/no question
  2. For “classifying tSCI with neurological examination”, it is considered as “yes” if responded using International Standards for Neurological Classification of SCI examination [17] or clinical definition (e.g., sensory-motor deficit)
  3. For “have a multidisciplinary team”, it is considered as “yes” if indicated having all the following positions caring for patients with tSCI in acute: surgeon (spine, ortho- or neuro-), nurse (registered nurse, registered practice nurse, or licensed practice nurse), rehabilitation physician/ physiatrist, physiotherapist (PT), occupational therapist (OT), social worker or case manager, psychologist [18]; in rehabilitation: rehabilitation physician/physiatrist, PT, OT, nurses (registered nurse or licensed practice nurse), psychologist, speech-language pathologist, case manager/social worker [19]
  4. For “provide services for detection and treatment for mental health”, it is considered as “yes” if indicated any of the following: monitor mental health/emotional wellbeing, provide education, screening with no assessment tool, screening with the use of standardized assessment tool, interview and diagnosis conducted by appropriate healthcare provider, intervention strategies, including medication, counselling/psychotherapy, exercise/activation, self-management, reassessment prior to discharge, train staff to recognize symptoms of depression, anxiety, post-traumatic stress disorder, etc
  5. For “provide SCI medical/rehabilitation follow-up”, it is considered as “yes” if answered “regularly” or “as needed” to the question “do you provide SCI medical/rehabilitation-related follow-up services after discharge?”
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BMC Health Services Research

ISSN: 1472-6963

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