The Global Spine Care Initiative: model of care and implementation

Claire D Johnson^{1

2}, Scott Haldeman^{3

4

5}, Roger Chou^{6

7}, Margareta Nordin^{8

9}, Bart N Green^{10

11}, Pierre Côté^{12

13}, Eric L Hurwitz¹⁴, Deborah Kopansky-Giles^{15

16}, Emre Acaroğlu¹⁷, Christine Cedraschi^{18

19}, Arthur Ameis²⁰, Kristi Randhawa^{12

13}, Ellen Aartun¹³, Afua Adjei-Kwayisi²¹, Selim Ayhan²², Amer Aziz²³, Teresa Bas²⁴, Fiona Blyth²⁵, David Borenstein²⁶, O'Dane Brady²⁷, Peter Brooks²⁸, Connie Camilleri²⁹, Juan M Castellote³⁰, Michael B Clay³¹, Fereydoun Davatchi³², Jean Dudler³³, Robert Dunn³⁴, Stefan Eberspaecher³⁵, Juan Emmerich³⁶, Jean Pierre Farcy³⁷, Norman Fisher-Jeffes³⁸, Christine Goertz³⁹, Michael Grevitt⁴⁰, Erin A Griffith⁴¹, Najia Hajjaj-Hassouni⁴², Jan Hartvigsen^{43

44}, Maria Hondras⁴⁵, Edward J Kane⁴⁶, Julie Laplante⁴⁷, Nadège Lemeunier⁴⁸, John Mayer⁴⁹, Silvano Mior⁵⁰, Tiro Mmopelwa⁵¹, Michael Modic⁵², Jean Moss⁵⁰, Rajani Mullerpatan⁵³, Elijah Muteti⁵⁴, Lillian Mwaniki⁵⁵, Madeleine Ngandeu-Singwe⁵⁶, Geoff Outerbridge⁵⁷, Shanmuganathan Rajasekaran⁵⁸, Heather Shearer¹³, Matthew Smuck⁵⁹, Erkin Sönmez⁶⁰, Patricia Tavares⁵⁰, Anne Taylor-Vaisey¹³, Carlos Torres⁶¹, Paola Torres⁶², Alexander van der Horst^{63

64}, Leslie Verville^{12

13}, Emiliano Vialle⁶⁵, Gomatam Vijay Kumar⁶⁶, Adriaan Vlok⁶⁷, William Watters 3rd^{68

69}, Chung Chek Wong⁷⁰, Jessica J Wong¹³, Hainan Yu^{12

13}, Selcen Yüksel⁷¹

Affiliations

¹ National University of Health Sciences, Lombard, IL, USA. globalspinecareinitiative@gmail.com.
² Qualcomm Health Center, Stanford Health Care, San Diego, CA, USA. globalspinecareinitiative@gmail.com.
³ Department of Epidemiology, School of Public Health, University of California Los Angeles, Los Angeles, CA, USA.
⁴ Department of Neurology, University of California, Irvine, Irvine, CA, USA.
⁵ World Spine Care, Santa Ana, CA, USA.
⁶ Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OR, USA.
⁷ Department of Medicine, Oregon Health and Science University, Portland, OR, USA.
⁸ Departments of Orthopedic Surgery and Environmental Medicine, New York University, New York, NY, USA.
⁹ World Spine Care Europe, Holmfirth, UK.
¹⁰ National University of Health Sciences, Lombard, IL, USA.
¹¹ Qualcomm Health Center, Stanford Health Care, San Diego, CA, USA.
¹² Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada.
¹³ UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada.
¹⁴ Office of Public Health Studies, University of Hawai`i, Mānoa, Honolulu, HI, USA.
¹⁵ Department of Research, Canadian Memorial Chiropractic College, Toronto, ON, Canada.
¹⁶ Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.
¹⁷ ARTES Spine Center, Ankara, Turkey.
¹⁸ Division of General Medical Rehabilitation, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland.
¹⁹ Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland.
²⁰ Certification Program in Insurance Medicine and MedicoLegal Expertise, Faculty of Medicine, University of Montreal, Toronto, ON, Canada.
²¹ Ridge Regional Hospital, Ghana World Spine Care, Accra, Greater Accra, Ghana.
²² ARTES Spine Center, Acibadem University, Ankara, Turkey.
²³ Orthopaedics and Spine Department, Ghurki Trust Teaching Hospital, Lahore, Punjab, Pakistan.
²⁴ Department of Surgery, Hospital Universitario and Politecnico La Fe, Valencia University, Valencia, Spain.
²⁵ Concord Clinical School, University of Sydney, Concord, NSW, Australia.
²⁶ Arthritis and Rheumatism Associates, The George Washington University Medical Center, Potomac, MD, USA.
²⁷ World Spine Care, Tampa, FL, USA.
²⁸ Centre for Health Policy, School of Population and Global Health, University of Melbourne, Toorak, Melbourne, VIC, Australia.
²⁹ St Michael's Hospital, North York, ON, Canada.
³⁰ National School of Occupational Medicine, Carlos III Institute of Health and Physical Medicine and Rehabilitation, University of Complutense, Madrid, Madrid, Spain.
³¹ Rehabilitation Care Line, Physical Medicine and Rehabilitation, Cincinnati Veterans Affairs Medical Center, Cincinnati, OH, USA.
³² Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Tehran, Iran.
³³ Department of Rheumatology, HFR Fribourg - Hospital Cantonal, Fribourg, FR, Switzerland.
³⁴ Department of Orthopaedic Surgery, Groote Schuur Hospital, University of Cape Town, Cape Town, Western Cape, South Africa.
³⁵ Department of Orthopedics, Princess Marina Hospital, Gaborone, Botswana.
³⁶ University of La Plata, La Plata, Buenos Aires, Argentina.
³⁷ Department of Orthopedic Surgery (retired), New York University, Piermont, NY, USA.
³⁸ Private Practice - Panorama Medi Clinic and Sessional Consultant, Groote Schuur Hospital, Cape Town, Western Cape, South Africa.
³⁹ Palmer College of Chiropractic, The Spine Institute for Quality, Davenport, IA, USA.
⁴⁰ Nottingham University Hospitals, Edwalton, Nottingham, UK.
⁴¹ Emergency Medicine, Carlsbad, CA, USA.
⁴² Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco.
⁴³ Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
⁴⁴ Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark.
⁴⁵ Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS, USA.
⁴⁶ College of Rehabilitative Sciences, Doctor of Physical Therapy Program, University of St. Augustine for Health Sciences, San Marcos, CA, USA.
⁴⁷ School of Sociological and Anthropological Studies, University of Ottawa, Ottawa, ON, Canada.
⁴⁸ Institut Franco-Européen de Chiropraxie, Toulouse, France.
⁴⁹ U.S. Spine and Sport Foundation, San Diego, CA, USA.
⁵⁰ Canadian Memorial Chiropractic College, Toronto, ON, Canada.
⁵¹ ARTES Ankara Spine Centre, Life Gaborone Hospital, Gaborone, Botswana.
⁵² Cleveland Clinic, Lerner College of Medicine, Cleveland, OH, USA.
⁵³ MGM School of Physiotherapy, Mahatma Gandhi Mission Institute of Health Sciences, Navi Mumbai, Maharashtra, India.
⁵⁴ Moi Teaching and Referral Hospital, Moi University, Eldoret, Kenya.
⁵⁵ Law Society of Kenya, Nairobi, Kenya.
⁵⁶ Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé, Center Region, Cameroon.
⁵⁷ World Spine Care, Canadian Memorial Chiropractic College, Chelsea, QC, Canada.
⁵⁸ Department of Orthopaedics and Spine Surgery, Ganga Hospital, Coimbatore, Tamilnadu, India.
⁵⁹ Department of Orthopaedic Surgery, Stanford University, Redwood City, CA, USA.
⁶⁰ Department of Neurological Surgery, Başkent University School of Medicine, Ankara, Turkey.
⁶¹ Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.
⁶² Exercise Science Laboratory, Faculty of Medicine, School of Kinesiology, Universidad Finis Terrae, Santiago, Chile.
⁶³ Department of Surgery, University of Namibia, Windhoek, Namibia.
⁶⁴ Central Hospital, Windhoek, Namibia.
⁶⁵ Catholic University of Parana, Curitiba, Paraná, Brazil.
⁶⁶ AMRI Hospitals, Salt Lake, Kolkata, West Bengal, India.
⁶⁷ Division of Neurosurgery, University of Stellenbosch, Bellville, Western Cape, South Africa.
⁶⁸ Department of Orthopedic, Weill Cornell Medical School, Institute of Academic Medicine, Houston Methodist Hospital, Houston, TX, USA.
⁶⁹ Department of Orthopedic Surgery, University of Texas Medical Branch, Galveston, TX, USA.
⁷⁰ Sarawak General Hospital, Kuching, Sarawak, Malaysia.
⁷¹ Department of Biostatistics, Ankara Yildirim Beyazit University Medical School, Ankara, Turkey.

PMID: 30151805
DOI: 10.1007/s00586-018-5720-z

The Global Spine Care Initiative: model of care and implementation

Claire D Johnson et al. Eur Spine J. 2018 Sep.

. 2018 Sep;27(Suppl 6):925-945.

doi: 10.1007/s00586-018-5720-z. Epub 2018 Aug 27.

Authors

Affiliations

¹ National University of Health Sciences, Lombard, IL, USA. globalspinecareinitiative@gmail.com.
² Qualcomm Health Center, Stanford Health Care, San Diego, CA, USA. globalspinecareinitiative@gmail.com.
³ Department of Epidemiology, School of Public Health, University of California Los Angeles, Los Angeles, CA, USA.
⁴ Department of Neurology, University of California, Irvine, Irvine, CA, USA.
⁵ World Spine Care, Santa Ana, CA, USA.
⁶ Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OR, USA.
⁷ Department of Medicine, Oregon Health and Science University, Portland, OR, USA.
⁸ Departments of Orthopedic Surgery and Environmental Medicine, New York University, New York, NY, USA.
⁹ World Spine Care Europe, Holmfirth, UK.
¹⁰ National University of Health Sciences, Lombard, IL, USA.
¹¹ Qualcomm Health Center, Stanford Health Care, San Diego, CA, USA.
¹² Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada.
¹³ UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada.
¹⁴ Office of Public Health Studies, University of Hawai`i, Mānoa, Honolulu, HI, USA.
¹⁵ Department of Research, Canadian Memorial Chiropractic College, Toronto, ON, Canada.
¹⁶ Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.
¹⁷ ARTES Spine Center, Ankara, Turkey.
¹⁸ Division of General Medical Rehabilitation, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland.
¹⁹ Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland.
²⁰ Certification Program in Insurance Medicine and MedicoLegal Expertise, Faculty of Medicine, University of Montreal, Toronto, ON, Canada.
²¹ Ridge Regional Hospital, Ghana World Spine Care, Accra, Greater Accra, Ghana.
²² ARTES Spine Center, Acibadem University, Ankara, Turkey.
²³ Orthopaedics and Spine Department, Ghurki Trust Teaching Hospital, Lahore, Punjab, Pakistan.
²⁴ Department of Surgery, Hospital Universitario and Politecnico La Fe, Valencia University, Valencia, Spain.
²⁵ Concord Clinical School, University of Sydney, Concord, NSW, Australia.
²⁶ Arthritis and Rheumatism Associates, The George Washington University Medical Center, Potomac, MD, USA.
²⁷ World Spine Care, Tampa, FL, USA.
²⁸ Centre for Health Policy, School of Population and Global Health, University of Melbourne, Toorak, Melbourne, VIC, Australia.
²⁹ St Michael's Hospital, North York, ON, Canada.
³⁰ National School of Occupational Medicine, Carlos III Institute of Health and Physical Medicine and Rehabilitation, University of Complutense, Madrid, Madrid, Spain.
³¹ Rehabilitation Care Line, Physical Medicine and Rehabilitation, Cincinnati Veterans Affairs Medical Center, Cincinnati, OH, USA.
³² Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Tehran, Iran.
³³ Department of Rheumatology, HFR Fribourg - Hospital Cantonal, Fribourg, FR, Switzerland.
³⁴ Department of Orthopaedic Surgery, Groote Schuur Hospital, University of Cape Town, Cape Town, Western Cape, South Africa.
³⁵ Department of Orthopedics, Princess Marina Hospital, Gaborone, Botswana.
³⁶ University of La Plata, La Plata, Buenos Aires, Argentina.
³⁷ Department of Orthopedic Surgery (retired), New York University, Piermont, NY, USA.
³⁸ Private Practice - Panorama Medi Clinic and Sessional Consultant, Groote Schuur Hospital, Cape Town, Western Cape, South Africa.
³⁹ Palmer College of Chiropractic, The Spine Institute for Quality, Davenport, IA, USA.
⁴⁰ Nottingham University Hospitals, Edwalton, Nottingham, UK.
⁴¹ Emergency Medicine, Carlsbad, CA, USA.
⁴² Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco.
⁴³ Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
⁴⁴ Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark.
⁴⁵ Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS, USA.
⁴⁶ College of Rehabilitative Sciences, Doctor of Physical Therapy Program, University of St. Augustine for Health Sciences, San Marcos, CA, USA.
⁴⁷ School of Sociological and Anthropological Studies, University of Ottawa, Ottawa, ON, Canada.
⁴⁸ Institut Franco-Européen de Chiropraxie, Toulouse, France.
⁴⁹ U.S. Spine and Sport Foundation, San Diego, CA, USA.
⁵⁰ Canadian Memorial Chiropractic College, Toronto, ON, Canada.
⁵¹ ARTES Ankara Spine Centre, Life Gaborone Hospital, Gaborone, Botswana.
⁵² Cleveland Clinic, Lerner College of Medicine, Cleveland, OH, USA.
⁵³ MGM School of Physiotherapy, Mahatma Gandhi Mission Institute of Health Sciences, Navi Mumbai, Maharashtra, India.
⁵⁴ Moi Teaching and Referral Hospital, Moi University, Eldoret, Kenya.
⁵⁵ Law Society of Kenya, Nairobi, Kenya.
⁵⁶ Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé, Center Region, Cameroon.
⁵⁷ World Spine Care, Canadian Memorial Chiropractic College, Chelsea, QC, Canada.
⁵⁸ Department of Orthopaedics and Spine Surgery, Ganga Hospital, Coimbatore, Tamilnadu, India.
⁵⁹ Department of Orthopaedic Surgery, Stanford University, Redwood City, CA, USA.
⁶⁰ Department of Neurological Surgery, Başkent University School of Medicine, Ankara, Turkey.
⁶¹ Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.
⁶² Exercise Science Laboratory, Faculty of Medicine, School of Kinesiology, Universidad Finis Terrae, Santiago, Chile.
⁶³ Department of Surgery, University of Namibia, Windhoek, Namibia.
⁶⁴ Central Hospital, Windhoek, Namibia.
⁶⁵ Catholic University of Parana, Curitiba, Paraná, Brazil.
⁶⁶ AMRI Hospitals, Salt Lake, Kolkata, West Bengal, India.
⁶⁷ Division of Neurosurgery, University of Stellenbosch, Bellville, Western Cape, South Africa.
⁶⁸ Department of Orthopedic, Weill Cornell Medical School, Institute of Academic Medicine, Houston Methodist Hospital, Houston, TX, USA.
⁶⁹ Department of Orthopedic Surgery, University of Texas Medical Branch, Galveston, TX, USA.
⁷⁰ Sarawak General Hospital, Kuching, Sarawak, Malaysia.
⁷¹ Department of Biostatistics, Ankara Yildirim Beyazit University Medical School, Ankara, Turkey.

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.

Keywords: Global burden of disease; Musculoskeletal system; Quality of health care; Spinal diseases.

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References

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The Global Spine Care Initiative: model of care and implementation

Affiliations

The Global Spine Care Initiative: model of care and implementation

Authors

Affiliations

Abstract

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical