SCOAP Community Speaks Up: Spine SCOAP

Surgeons at Virginia Mason have asked, “How can we get inovolved in the new SCOAP registry for spine surgery currently being developed?”

The surgical treatment of the human spine can be challenging in diagnosis, surgical decision-making, and technical execution. While there is general agreement among spine surgeons on appropriate care pathways, substantial variation exists in the rates of surgery, delivery and costs of care, and outcomes. Individual hospital sites often struggle with meeting the best practices involved in caring for this population, largely because they have limited tracking of performance or pathways to improve care delivery.

Beginning in 2009, a group of orthopedic and neurosurgeons became interested in developing a surveillance registry that would use the SCOAP platform because of its proven record as an impartial, objective, real world outcomes system not easily influenced by any stakeholder. A state-wide workgroup was formed and developed substantial momentum to choose metrics for process and outcome measures for a Spine data collection tool, with the goal of improving overall spine surgical care in Washington State. Led by a multidisciplinary group of clinicians across Washington State, this group is now poised to launch Spine SCOAP in several pilot hospitals beginning July 1.

Spine SCOAP is of particular importance because clinicians care for patients with serious, chronic diseases; use highly innovative, expensive, and emerging technology; function across a range of inpatient and outpatient practice settings; and count patient-reported outcomes as their most important treatment efficacy outcome. Stakeholders (Labor and Industries, industry, payers, regulators, advocacy groups) are interested and motivated to achieve the same goals (proof of benefit to patients, improving safety and quality of care) but for different, often competing, reasons. All see SCOAP as an objective, impartial, real world representation of truth that is not easily influenced by any stakeholder. Spine SCOAP fills a critical need in tracking care delivery and outcomes in this priority patient population and over time will allow best practices to emerge. SCOAP is also a proven platform for best practice dissemination through the Washington state community. By linking diverse practice environments across the continuum of care, Spine SCOAP benchmark reports allow clinicians to learn from one another and to perform statewide QI through benchmarking. Spine SCOAP aims to develop a diagnostic and outcomes surveillance registry vetted with providers and industry partners. Linking providers, industry partners, and patients is a unique approach for QI and will provide a necessary perspective for our community.

Currently the Spine SCOAP workgroup is finalizing the metrics and engaging surgeons across the state to encourage their hospitals to participate in this exciting work. The pilot data collection phase of Spine SCOAP starts July 1, for full deployment in January 2012. For more information about how you and your hospital can get involved, please contact Mike Kraemer at the Foundation for Healthcare Quality.

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