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140 - The MNI Spine Care Retention Project: How to effectively increase Patient Access

Thursday, February 27, 2025

5:00 PM - 6:30 PM MST

Presenting Author(s)

CC

Claire Callan, BA

Medical Student
Florida International University Herbert Wertheim College of Medicine
Coral Gables, Florida, United States

Co-Author(s)

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Ronald Tolchin, DO

Chair of Nonsurgical Spine Care and Rehabilitation, Kalman Bass Endowed Chair
Baptist Health Miami Neuroscience Institute
Miami, Florida, United States
AT

Alexandra Turcios, MS

Director of Advanced Practice Providers
Baptist Health Miami Neuroscience Institute
Miami, Florida, United States

Objectives: Low back and neck pain are common diagnoses in the South Florida urgent care settings. After a successful 2021 pilot by the orthopedics department, the Miami Neuroscience Institute (MNI) launched the "Spine Urgent Care Concierge Service" (SUCCS) with physiatrists and advanced practice providers (APPs). This initiative aims to improve patient retention, reduce the loss to follow-up of spine pain patients, and increase continuity of care. The MNI study evaluates this model, providing timely outpatient treatment for non-emergent spine care patients after emergency care referrals.

Design: Our ongoing project began in March 2022 and includes Baptist Health emergency departments, urgent cares, and express cares in Broward and Miami-Dade, Florida. Adult back pain patients are included, excluding patients with non-accepted insurance or motor vehicle accidents. ED physicians treat patients with medications or imaging and admit those with red flag symptoms. All other patients referred to the SUCCS are engaged through a decision tool that determines if they should be seen urgently (24-72 hours), routinely (1-2 weeks), or as needed.

Results: From 3/23/22-7/31/24, the SUCCS processed 5,667 referrals to MNI, scheduling 912 appointments with physiatrists or APPs. Of those, 562 patients attended clinic visits, with 336 (63%) seen within two weeks, averaging 6.1 business days. For patients needing more urgency within 72 hours (25%), the average wait was 4.6 days. Delays included patient preferences or the need for a PCP referral.

Conclusions: Our MNI pilot showed success in quickly scheduling spine care appointments within two weeks. About 16% of patients received appointments through SUCCS, with over 61% seen by clinic providers. Main reasons for the drop-off between referral and scheduling included patients not answering voicemails, symptom improvement, existing outside providers, or out-of-network insurance. Improving the referral process could enhance the ability of physiatrists and APPs to manage acute lower back and neck pain in emergency settings.