Nurse practitioner-led surgical spine consultation clinic

Abstract

Aim: This study is a report of a study of patient satisfaction with non-surgical nurse practitioner management of pre-selected spinal referrals.

Background: Nurse practitioners are linked to particular patient populations or specific physicians in a medical setting. In a universal healthcare delivery system, patients are often faced with long and anxiety-provoking waiting times, particularly for sub-specialized consultations such as spinal surgery.

Method: A nurse practitioner-led spine consultation ambulatory clinic was implemented at a Canadian neuroscience centre. A prospective patient satisfaction and clinical accuracy study was performed in 2008. All patients assessed by the nurse practitioner completed a post-consultation validated patient satisfaction questionnaire. All patients were reviewed with the surgeon for confirmation of diagnosis and management.

Results: A total of 177 pre-selected patients (disc-herniations, spinal stenosis, degenerative disc disease) were assessed by the nurse practitioner. Mean time from referral to nurse practitioner clinic assessment was 12 weeks (range: 9·8-21 weeks) compared with 10-52 weeks if seen in a conventional clinic. Nurse practitioner clinical diagnosis and management plan were in agreement with those of the surgeon (100% and 95% respectively). Patient satisfaction was 97% with the consultation and 94% and with examination thoroughness. Preference for a longer waiting period for direct consultation with the surgeon was 26%.

Conclusion: Nurse practitioners can play an effective and efficient role in providing care to patients requiring specific disease management in a specialty setting. The nurse practitioner-run clinic offers accurate and earlier assessment, thus facilitating a timelier diagnosis and management plan.