Abstract
Introduction
Orthopaedic Spinal Rapid Access Service (OSRAS) was developed in our institute to provide a structured pathway for management of urgent spinal pathologies during working hours of Monday to Friday. It was delivered through a published rota by a multi displinary team of Extended Scope Practitioner carrying a bleep and a Spinal Surgeon.
Aim
To evaluate the efficacy of OSRAS through a prospective audit.
Results
From Nov 2013 till April 2014, 177 patients (48 Male: 119 Females) with an average age of 50 (17–95) years were referred to OSRAS. Wednesday was the busiest day with 26% referral in AM and 74% in PM. Main source of referrals were: Regional MSK services (50), Triage (34), ED (27) and GPs (20). The reasons were: suspected CESI (n=100), Acute LBP (n=30), pathological fractures (n=23), progressive neurology (n=16), discitis (n=5) and spinal stenosis (n=2). Depending on clinical need 29 patients were seen on same day, 33 next day, 53 with in 2–5 days and 31 more than 5 days. Eighty patients were discharged, 36 listed for surgery, 27 required further follow up and 31 were given telephone advise only. High user satisfaction rating was obtained.
Conclusion
We propose an OSRAS model as an alternate to often un satisfactory current emergency department model, that can provide a structured pathway for timely expert management of serious spinal pathologies therefore prevent potential consequences whilst avoid unnecessary admissions.
Conflicts of interest: No conflicts of interest
Sources of funding: No funding obtained
