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  • Utility of a multidisciplinary case conference in the management of patients with spinal disorders.

    Final Number:

    Cheerag D. Upadhyaya MD; Brigid A Klamann RN; Seth M Oliphant BS; Stefan Eichenauer MD; Jennifer Elliott; Susan Opper MD; Brie E Reed RN; Jaishma Devaiah

    Study Design:

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2017 Annual Meeting - Late Breaking Science

    Introduction: Reimbursements are increasingly reliant upon value based purchasing / pay for performance rather than fee-for-service. One strategy to achieve high-value health care is to develop integrated practice units (IPUs) to deliver comprehensive care (1). A potential component of IPUs is the implementation of a multidisciplinary case conference to improve clinical decision-making.

    Methods: We implemented a multidisciplinary case conference involving neurosurgeons, physiatrists, pain specialists, physical therapists, occupational therapists, administrative staff, and nursing staff. We retrospectively reviewed all cases discussed at a multi-disciplinary spine care conference over an 18-month period. The primary outcome was a change in management plan as a result of case discussion.

    Results: Three hundred thirty cases were reviewed. The multidisciplinary case conference resulted in a change in proposed plan of management in 212 (64.2%) patients. New plans included obtaining further imaging, referral to another specialist for evaluation, change in target for epidural injections, modification of surgical plan. Additionally, the case discussions often identified opportunities to further enhance the integrated delivery of spine care.

    Conclusions: The multidisciplinary case conference influences treatment decisions in a significant proportion of cases in patients with spinal disorders while simultaneously enhancing the team dynamics of the IPU and identifying opportunities to enhance the integrated delivery of spine care within the health system.

    Patient Care: The development of a multidisciplinary case conference may potentially identify more appropriate and cost effective use of interventions in the care of patients with spinal disorders.

    Learning Objectives: By the conclusion of this session, participants should be able to: 1) Discuss the importance of integrated practice units in the delivery of comprehensive care. 2) Discuss the value of multidisciplinary case conference in the management of patients with spinal disorders. 3) Identify opportunities to implement an integrated delivery model within one's health system.

    References: Porter ME, Lee TH. The Strategy That Will Fix Health Care. Harvard Business Review. October 2013.

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