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The Spinal Invasiveness Score can better quantify surgical wait-lists across Canada
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The Spinal Invasiveness Score can better quantify surgical wait-lists across Canada
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Journal Article
The Spinal Invasiveness Score can better quantify surgical wait-lists across Canada
2025
Overview
Background: Canadian spine care delivery is in crisis owing to inordinate patient wait times. Relying on the current method of a simple count of patients awaiting surgery leads to disproportionate wait time estimations depending on pathology; for example, patients with scoliosis wait longer than those needing simple discectomies. Using the Spinal Invasiveness Score (SIS) to categorize surgeries is a comprehensive solution; it is a validated scoring system that assigns points based on surgical invasiveness across 6 parameters. Wait-lists can then be calculated based on SIS score, with additional benefits such as subcategorization of wait times and initiatives to target specific subcategories of procedures. This study aims to evaluate spine surgeons and hospital administrators perceptions of adopting the SIS model for spine surgery wait-list management. Methods: A qualitative descriptive study was conducted surveying spine surgeons and hospital administrators across Canada. Participants reviewed a case study comparing the current waitlist model with the SIS-based approach and were surveyed on their preferred method for wait time calculation. Responses were analyzed using thematic analysis to identify recurring themes around SIS's perceived benefits, limitations, and barriers to adoption. Results: Of the 21 respondents, 17 (81%) preferred the SIS approach over the existing system, including 9 of 11 surgeons and 8 of 10 administrators. Thematic analysis revealed several key perceived benefits of SIS including subcategorizing wait-lists (e.g., multilevel v. single-level; instrumented v. noninstrumented), better triaging of cases, and more accurate wait time calculation. Barriers identified included difficulty for the health system to capture SIS score for each surgery, cost of implementation, and SIS not capturing full complexity of cases such as elevated body mass index or revision status. Conclusion: The SIS method was overwhelmingly well received, with numerous benefits identified as well as potential barriers and room for improvement. The SIS score has shown early success in advocating for more tailored operating room (OR) scheduling, such as longer OR days to accommodate complex surgeries. With careful implementation and adaptation, SIS could become a key part of nationwide wait-list management strategies.
Publisher
CMA Impact Inc,CMA Impact, Inc
Subject
