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Clinical Outcomes

The TRUE definition of quality is reduction of variation about the mean. As quality experts note, unless you have data, you have no business talking about quality. Kenai Spine is a work in progress with the goal of improving how we care for back and neck patients over the next year. We will also be tracking and publishing spine clinical outcomes and patient satisfaction, which is already in process.spine center alaska, spine treatment alaska, spine care alaska, alaska spine center kenai peninsula treatment for neck and back pain

New patients coming into Kenai Spine will complete an intake form that measures their pain level, severity of symptoms and functional status. Three months after their first visit, a nurse will call a random sample of these patients and interview them for functional status, current symptoms and patient satisfaction. This is the most unbiased, statistically relevant method for outcomes analysis.

The clinical outcomes are then analyzed by an outside firm that specializes in tracking spine outcomes, and is involved with other spine centers across the U.S. The following is the type of information that will be measured and published about Kenai Spine in the future.

Clinical outcome highlights at Kenai Spine — 2016

  • Percent of patients who had therapy as part of their care = 69%

  • Percent of patients who received spinal injections as a non-surgical treatment alternative = 34%

  • Percent of patients receiving a Home Remedy Book with non-surgical advice = 38%

  • Percent of patients receiving a Home Exercise Program = 56%

  • Percent of patients who would recommend the clinic to a friend = 88%

  • Percent of patients who were satisfied with their overall care = 90%

Quality is a journey, however, rather than a destination, and we are committed to continually improving. The clinical outcome and patient satisfaction data we publish will document our footprints on that journey.


PATIENT SEVERITY: Kenai Spine handles the most extreme cases of back and neck pain

Kenai Spine was founded in 2011 to address the many complex cases of back and neck pain in Alaska. Over the past five years, Kenai Spine has evolved into a regional spine center of excellence and is referred the most complex cases of back and neck pain from across the State. One of four patients coming in the front door have had previous back or neck surgery at other clinics. Additionally, half of new patients coming to the spine center have symptoms like radiating pain or numbness into a leg or arm, which implies disc-related symptoms, rather than simple acute back or neck strain. Another 74% of these new patients had suffered from back or neck pain for 4 months or longer. This severity of new patients presents a challenge for a spine center. Still, the spine center emphasized non-surgical options first, holding surgery as the last resort.


Emphasizing conservative options first for a “Stairway to Success”

A true multidisciplinary spine center should emphasize conservative treatment options first like therapy and pain-relieving spinal injections to lessen the need for spine surgery, which should form a downward Stairway to Success as shown in this chart. This stairway documents that the more you emphasize NON-surgical treatment options like physical therapy or injections, fewer patients will need to resort to surgery for relief of symptoms. Consequently, 79% of patients recovered from pain symptoms without surgery. Patient education is another focus of the spine center as 56% received a customized home exercise program in 2016 to prevent recurrence.


Patient satisfaction

A phone survey is used to audit patient satisfaction — the most accurate survey method possible. That’s because mail surveys have an inherent sampling bias based on those who take the time to respond. Three months after the first visit an outside RN (not affiliated or employed by the center) calls a random sample of patients at home. The nurse then interviews patients on their satisfaction with the doctor seen, the time the doctor spends with the patient, the medical explanation provided, etc. At Kenai Spine 90% of patients said they were satisfied with the overall care provided to them.


Resolving weakness & prescribing an Rx of exercise

The main reason people go to the doctor is for relief of pain. But if a spine physician focuses exclusively on pain, he can miss the target of return to activity. For example, spine specialized therapists move the patient quickly into exercise. At intake, 41% of patients rated their pain level at 7 or more on a 1-10 analog pain scale. After three months, it improved to only 20%. A significant number of patients had relief from disc-related symptoms. At intake 49% cited weakness in an arm or leg, which improved to only 32%. At the same time patients reduced their use of pills, from 26% of new patients taking 5 or pills daily to only 16% after treatment.


Return to work & activity

Having a more complex patient mix makes return to work more difficult than a clinic that treats simple back pain. For example, of those patients who had simple acute back or neck pain in this year’s sample, 100% returned to work and activity. The majority of patients, however, were either chronic back pain or those with failed back surgery syndrome from other clinics. Case in point: 26% of new patients coming to Kenai Spine had previous back surgery elsewhere, and 86% of these patients returned to work/activity. Of those with back pain longer than 4 months with disc-related symptoms, 85% returned to work/activity.

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Patient Success Stories
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Surgery repairs damaged disc and returns outdoorsman to activity.

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Paramedic gets back to life with Kenai Spine.

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Healthcare CEO back on the job after pain relieving spine surgery.

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School administrator recovers from back pain without surgery.

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Dog sled champion back on the trails after non-surgical treatment.