Spine Colorado - Clinical Outcome Report Cards

Outcomes: The first step of the journey toward quality

Few physicians or hospitals provide statistical information that documents quality. As a Center of Excellence, SpineColorado collects severity and outcome data for continual quality improvement. The statistical data provided in this report card document the following:

At intake 20% of patients were taking 5 or more pills daily for pain relief. After three months treatment at SpineColorado, the number declined to only 9%.
Only 11% of patients needed surgery, compared to 25% or more elsewhere.
Patient satisfaction scores averaged above 95% in all 7 categories measured.

Clinical outcome highlights at SpineColorado

24 % of patients who had therapy as part of their care

36% of patients who had injections as part of their care

11% of patients who had surgery as part of their care

89% of chronic patients who returned to work

99% of patients who were satisfied with the time the doctor spent with them

99% of patients who were satisfied with the doctor’s explanation of medical problem

93% of patients who would be likely to recommend the clinic to a friend

SpineColorado: a Center of Excellence for back & neck pain
The trend in medicine is to explore non-surgical solutions to various health problems. The same trend is occurring in the area of spine care. But compared to other countries, back pain sufferers in the United States have twice as much back and neck surgery.

SpineColorado is committed to a non-surgical, activity-oriented approach to back and neck pain. For example, SpineColorado uses written clinical protocols to emphasize a non-surgical approach first, and surgery is held as the last resort.

The TRUE definition of quality is reduction of variation about the mean. As quality experts note, unless you have data, you simply have no business talking about quality. New patients coming into SpineColorado completed a clinical outcome tool that measured their pain level, severity of symptoms and functional status. Three months after their visit, a nurse called a random sample of these patients and interviewed them for functional status, current symptoms and patient satisfaction. This is the most unbiased, statistically relevant method for outcomes analysis.

The clinical outcomes presented here are analyzed by an outside firm that specializes in tracking spine outcomes, and is involved with other spine Centers of Excellence nationally. The results show that SpineColorado receives at its front door a complex patient base. Half of all new patients had serious neurological symptoms like pain radiating beyond a knee or elbow, which can imply a serious disc-related problem. But even with a complex patient base, the center had impressive outcomes. Only 11% needed surgery. As to patient satisfaction, SpineColorado averaged above 95% for all seven categories measured.

Quality is a journey, however, rather than a destination, and we are committed to continually improving. This report documents our footprints on that journey.

Severity of new patients coming to the spine center 2005

Patient satisfaction outcomes 2005

Patient satisfaction
A phone survey is used to audit patient satisfaction. This method is the most accurate survey method possible. That’s because mail surveys have an inherent sampling bias based on those who take the time to respond. Three months after the first visit to SpineColorado, a nurse calls a random sample of patients at home. The nurse then interviews patients on their satisfaction with the doctor seen, the time the doctor spends with the patient, the medical explanation provided, etc. SpineColorado averaged over 95% for all seven categories measured, with 93% of patients saying they would recommend the clinic to a friend.

Return to function outcomes 2005

Pain relief through function
The main reason people go to the doctor is for relief of pain. But if a spine clinic focuses exclusively on pain, it can miss the target of return to function. Spine specialized physical therapists provide pain relief and then move the patient quickly into supervised exercise. This chart shows that SpineColorado has good success relieving pain, eliminating numbness and radiating pain in legs or arms, and ultimately returning the back pain sufferer to activity — after only 3 months of care. The gains in function did not come from pills either. For example, the percent of patients relying heavily on pills for pain control declined from 20% to 9% after 3 months. Self-reported pain levels decreased, and function improved.

Return to work outcomes 2005

Return to work & activity
Having a more complex patient mix makes return to work more difficult than an occupational medicine clinic, or primary care clinic that treats simple onsets of acute back pain that can go away on their own.

The vast majority of patients coming to SpineColorado were chronic or complex, meaning they had back pain for more than 4 months, or had radicular pain below a knee or elbow. The other problem patient mix are those patients coming to the clinic with previous failed back surgery.

In this year’s study sample, 89% of simple/complex patients were back to work within 3 months after visiting SpineColorado. Of those who came to the clinic with previous back surgery, 77% were back to work.

The non-surgical approach

A non-surgical approach to back & neck pain
SpineColorado uses physiatrists, therapists to ensure patients get 6 weeks of non-surgical care absent red flag symptoms. Consequently, even though 15% of NEW patients were “failed back surgeries” from other clinics, and 48% of new patients had pain radiating below a knee or elbow (implying a disc problem), only 11% of patients needed surgery to recover from back and neck pain symptoms, a much lower surgical rate than at other clinics with such a complex patient mix at intake.

Need more information on back and neck pain?
Click here to view resource books on spine problems, what causes back pain, what causes neck pain and when to see the doctor.