For individuals who sustain a spinal cord injury, the type of treatment and care they receive in the following days, weeks and months after their injury occurs are critical in determining their long-term outcomes. However, each hospital has its own set of protocols and it is not uncommon for care to vary depending on which hospital that individual is sent to. Creating a set of best practices specific to SCI that hospitals can work towards facilitates not only standardized care for individuals with a SCI, but optimized care as well.
Setting the bar - accreditation standards for SCI care
In 2012, RHI partnered with Accreditation Canada (AC), the preeminent healthcare accreditation body in Canada, to develop a set of comprehensive and evidence-based standards for spinal cord injury called the SCI Standards of Care (SCI Standards). These Standards are available for Acute and Rehabilitation Services and are part of AC's existing Qmentum accreditation program, which hospitals already participate in. The SCI Standards are the first set of accreditation standards designed specifically for spinal cord injury with a focus on improving quality of care through effective service design, use of best practices, enhancing staff competency, early intervention, preventing and monitoring secondary complications and early initiation of rehabilitation services. Hospitals with specialized SCI programs that opt to participate use the process to review their SCI programs against standards of excellence in order to improve patient outcomes and create efficiencies in the way care is provided. Accrediting hospitals and rehabilitation facilities with the SCI Standards help ensure that Canadians with SCI receive consistent, quality care no matter which hospital with specialized SCI programs they receive treatment at.
Standardization of care benefits not only patients, but also the health care system overall by reducing unintended variation in care that is not driven by evidence-based practice, thereby making more effective use of resources, improving patients' health outcomes, and reducing the burden on the healthcare system.
As a result of this collaboration and in coordination with the Rick Hansen SCI Registry, 13 hospitals and/or rehabilitation facilities with SCI programs have successfully implemented the SCI Standards to date, leading to enhanced and more consistent care for individuals who sustain a traumatic or non-traumatic SCI in Canada. For a complete list of accredited hospitals, see map below.
The creation and implementation of the SCI Standards is a key achievement for RHI as we strive to optimize care for all individuals sustaining a SCI. To further enhance the standards and accreditation process, RHI partnered with the Health Standards Organization (HSO), an affiliate of AC, to embark on the next phase of accreditation. The new initiative will focus on:
- Learning from accredited facilities, non-accredited facilities and other impacted stakeholders about the value of the accreditation standards to them; and
- Identifying challenges and opportunities in order to enhance the accreditation process across all aspects of care (acute care, rehabilitation and community living).
By taking a people-centered approach, this initiative will engage people with lived experience of SCI, inviting individuals to act as partners and provide their experiences throughout their care journey from acute and rehabilitation care to living with SCI in the community. In gathering and analyzing this information, the next phase of the accreditation program will be better equipped to address the specific needs of the SCI community.
RHI continues to support hospitals in adopting the SCI Standards through the development of the Accreditation Toolkit. The toolkit includes an accessible library of resources that clinicians and policy makers can use to change practice (e.g. clinical practice guidelines, pre-printed orders), and frequently asked questions regarding the accreditation process.
As of June 2019, 13 SCI centers that participate in the Rick Hansen SCI Registry have successfully fulfilled the SCI Standards. Congratulations to all involved, which demonstrates a real commitment to excellence in SCI care.