The Global Spine Care Initiative: model of care and implementation

Johnson CD 1 , Haldeman S 2 , Chou R 3 , Nordin M 4 , Green BN 5 , Côté P 6 Show all authors , Hurwitz EL 7 , Kopansky-Giles D 8 , Acaroğlu E 9 , Cedraschi C 10 , Ameis A 11 , Randhawa K 6 , Aartun E 12 , Adjei-Kwayisi A 13 , Ayhan S 14 , Aziz A 15 , Bas T 16 , Blyth F 17 , Borenstein D 18 , Brady O 19 , Brooks P 20 , Camilleri C 21 , Castellote JM 22 , Clay MB 23 , Davatchi F 24 , Dudler J 25 , Dunn R 26 , Eberspaecher S 27 , Emmerich J 28 , Farcy JP 29 , Fisher-Jeffes N 30 , Goertz C 31 , Grevitt M 32 , Griffith EA 33 , Hajjaj-Hassouni N 34 , Hartvigsen J 35 , Hondras M 36 , Kane EJ 37 , Laplante J 38 , Lemeunier N 39 , Mayer J 40 , Mior S 41 , Mmopelwa T 42 , Modic M 43 , Moss J 41 , Mullerpatan R 44 , Muteti E 45 , Mwaniki L 46 , Ngandeu-Singwe M 47 , Outerbridge G 48 , Rajasekaran S 49 , Shearer H 12 , Smuck M 50 , Sönmez E 51 , Tavares P 41 , Taylor-Vaisey A 12 , Torres C 52 , Torres P 53 , van der Horst A 54 , Verville L 6 , Vialle E 55 , Kumar GV 56 , Vlok A 57 , Watters W 58 , Wong CC 59 , Wong JJ 12 , Yu H 6 , Yüksel S 60

Affiliations 

  • 1 National University of Health Sciences, Lombard, IL, USA. [email protected]
  • 2 Department of Epidemiology, School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
  • 3 Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OR, USA
  • 4 Departments of Orthopedic Surgery and Environmental Medicine, New York University, New York, NY, USA
  • 5 National University of Health Sciences, Lombard, IL, USA
  • 6 Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada
  • 7 Office of Public Health Studies, University of Hawai`i, Mānoa, Honolulu, HI, USA
  • 8 Department of Research, Canadian Memorial Chiropractic College, Toronto, ON, Canada
  • 9 ARTES Spine Center, Ankara, Turkey
  • 10 Division of General Medical Rehabilitation, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland
  • 11 Certification Program in Insurance Medicine and MedicoLegal Expertise, Faculty of Medicine, University of Montreal, Toronto, ON, Canada
  • 12 UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
  • 13 Ridge Regional Hospital, Ghana World Spine Care, Accra, Greater Accra, Ghana
  • 14 ARTES Spine Center, Acibadem University, Ankara, Turkey
  • 15 Orthopaedics and Spine Department, Ghurki Trust Teaching Hospital, Lahore, Punjab, Pakistan
  • 16 Department of Surgery, Hospital Universitario and Politecnico La Fe, Valencia University, Valencia, Spain
  • 17 Concord Clinical School, University of Sydney, Concord, NSW, Australia
  • 18 Arthritis and Rheumatism Associates, The George Washington University Medical Center, Potomac, MD, USA
  • 19 World Spine Care, Tampa, FL, USA
  • 20 Centre for Health Policy, School of Population and Global Health, University of Melbourne, Toorak, Melbourne, VIC, Australia
  • 21 St Michael's Hospital, North York, ON, Canada
  • 22 National School of Occupational Medicine, Carlos III Institute of Health and Physical Medicine and Rehabilitation, University of Complutense, Madrid, Madrid, Spain
  • 23 Rehabilitation Care Line, Physical Medicine and Rehabilitation, Cincinnati Veterans Affairs Medical Center, Cincinnati, OH, USA
  • 24 Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Tehran, Iran
  • 25 Department of Rheumatology, HFR Fribourg - Hospital Cantonal, Fribourg, FR, Switzerland
  • 26 Department of Orthopaedic Surgery, Groote Schuur Hospital, University of Cape Town, Cape Town, Western Cape, South Africa
  • 27 Department of Orthopedics, Princess Marina Hospital, Gaborone, Botswana
  • 28 University of La Plata, La Plata, Buenos Aires, Argentina
  • 29 Department of Orthopedic Surgery (retired), New York University, Piermont, NY, USA
  • 30 Private Practice - Panorama Medi Clinic and Sessional Consultant, Groote Schuur Hospital, Cape Town, Western Cape, South Africa
  • 31 Palmer College of Chiropractic, The Spine Institute for Quality, Davenport, IA, USA
  • 32 Nottingham University Hospitals, Edwalton, Nottingham, UK
  • 33 Emergency Medicine, Carlsbad, CA, USA
  • 34 Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco
  • 35 Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
  • 36 Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS, USA
  • 37 College of Rehabilitative Sciences, Doctor of Physical Therapy Program, University of St. Augustine for Health Sciences, San Marcos, CA, USA
  • 38 School of Sociological and Anthropological Studies, University of Ottawa, Ottawa, ON, Canada
  • 39 Institut Franco-Européen de Chiropraxie, Toulouse, France
  • 40 U.S. Spine and Sport Foundation, San Diego, CA, USA
  • 41 Canadian Memorial Chiropractic College, Toronto, ON, Canada
  • 42 ARTES Ankara Spine Centre, Life Gaborone Hospital, Gaborone, Botswana
  • 43 Cleveland Clinic, Lerner College of Medicine, Cleveland, OH, USA
  • 44 MGM School of Physiotherapy, Mahatma Gandhi Mission Institute of Health Sciences, Navi Mumbai, Maharashtra, India
  • 45 Moi Teaching and Referral Hospital, Moi University, Eldoret, Kenya
  • 46 Law Society of Kenya, Nairobi, Kenya
  • 47 Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé, Center Region, Cameroon
  • 48 World Spine Care, Canadian Memorial Chiropractic College, Chelsea, QC, Canada
  • 49 Department of Orthopaedics and Spine Surgery, Ganga Hospital, Coimbatore, Tamilnadu, India
  • 50 Department of Orthopaedic Surgery, Stanford University, Redwood City, CA, USA
  • 51 Department of Neurological Surgery, Başkent University School of Medicine, Ankara, Turkey
  • 52 Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
  • 53 Exercise Science Laboratory, Faculty of Medicine, School of Kinesiology, Universidad Finis Terrae, Santiago, Chile
  • 54 Department of Surgery, University of Namibia, Windhoek, Namibia
  • 55 Catholic University of Parana, Curitiba, Paraná, Brazil
  • 56 AMRI Hospitals, Salt Lake, Kolkata, West Bengal, India
  • 57 Division of Neurosurgery, University of Stellenbosch, Bellville, Western Cape, South Africa
  • 58 Department of Orthopedic, Weill Cornell Medical School, Institute of Academic Medicine, Houston Methodist Hospital, Houston, TX, USA
  • 59 Sarawak General Hospital, Kuching, Sarawak, Malaysia
  • 60 Department of Biostatistics, Ankara Yildirim Beyazit University Medical School, Ankara, Turkey
Eur Spine J, 2018 09;27(Suppl 6):925-945.
PMID: 30151805 DOI: 10.1007/s00586-018-5720-z

Abstract

PURPOSE: Spine-related disorders are a leading cause of global disability and are a burden on society and to public health. Currently, there is no comprehensive, evidence-based model of care for spine-related disorders, which includes back and neck pain, deformity, spine injury, neurological conditions, spinal diseases, and pathology, that could be applied in global health care settings. The purposes of this paper are to propose: (1) principles to transform the delivery of spine care; (2) an evidence-based model that could be applied globally; and (3) implementation suggestions.

METHODS: The Global Spine Care Initiative (GSCI) meetings and literature reviews were synthesized into a seed document and distributed to spine care experts. After three rounds of a modified Delphi process, all participants reached consensus on the final model of care and implementation steps.

RESULTS: Sixty-six experts representing 24 countries participated. The GSCI model of care has eight core principles: person-centered, people-centered, biopsychosocial, proactive, evidence-based, integrative, collaborative, and self-sustaining. The model of care includes a classification system and care pathway, levels of care, and a focus on the patient's journey. The six steps for implementation are initiation and preparation; assessment of the current situation; planning and designing solutions; implementation; assessment and evaluation of program; and sustain program and scale up.

CONCLUSION: The GSCI proposes an evidence-based, practical, sustainable, and scalable model of care representing eight core principles with a six-step implementation plan. The aim of this model is to help transform spine care globally, especially in low- and middle-income countries and underserved communities. These slides can be retrieved under Electronic Supplementary Material.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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