Conservative care first cut imaging and the surgical queue at once
Low back pain was going straight to imaging and surgical referral. Nationally, 30% of low back pain patients without red flags still received imaging, and the wait for spine surgical assessment ran to months.
−31%
referral MRI use
Employer
422 Ontario patients
Sector
Shared care model
Scale
10% of all patients in the study period
Period
2017 publication
What they did
Advanced practice clinician triage of low back pain referrals across a networked shared care model, with conservative care as the first step.
What was measured
Referral MRI use
decreased by 31%
Referral MRI use under a shared care low back pathway
Wait to surgical assessment, Toronto site
a mean of 6 (range 1-19) months compared with 38 days
Wait to spine surgical assessment, before and after the pathway
Baseline unnecessary imaging rate
30%
Low back pain patients without red flags who still received imaging
Canadian Institute for Health Information, in collaboration with Choosing Wisely Canada
$232 million (5%) per year
Annual reduction in the burden of illness attributable to physiotherapy
Deloitte LLP, prepared for Canadian Physiotherapy Association
from an average of 130 days to 69 days
Wait to spine surgical assessment under a multidisciplinary pathway
What this means for your site
Triage is what a physiotherapist on site does all day. Sorting the worker who needs a specialist from the worker who needs 6 weeks of loading is the highest value decision in the pathway, and it is cheapest to make early.
Measure yours.
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