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Final Program


Final Program

860 - PM&R Consults & Elective Spine Surgeries: A Quality Improvement Project

Friday, February 28, 2025
5:00 PM - 6:30 PM MST
Objectives: Previous research shows that timely Physical Medicine and Rehabilitation (PM&R) consults improve patient outcomes and reduce hospital stays. This project aimed to increase appropriate PM&R consults for elective spine surgery patients using the AM-PAC tool, which assesses activity limitations. Consults were considered appropriate when patients scored ≤16 on physical and occupational therapy assessments. Three Plan-Do-Study-Act (PDSA) cycles were used to improve the screening and consult process.

Design:

Seven Advanced Practice Providers (APPs) participated in a 12-week baseline period followed by three 12-week PDSA cycles. Each APP was trained, surveyed on teamwork, and received feedback during screenings. The team tracked consult accuracy, and APPs received a PM&R consult suggestion page for missed consults.

Results: Baseline screening accuracy (Weeks 1–11) was under 20%. PDSA Cycle One (Week 12) involved training on the screening process, resulting in a spike in accuracy, peaking at 100% by week 14. However, accuracy declined afterward. PDSA Cycle Two (Week 25) included email reminders and notifications about individual APP success rates, leading to a gradual improvement in accuracy, but less pronounced than the first cycle.

Conclusions: PDSA Cycle One had an immediate but short-lived impact, while Cycle Two had a more modest effect. Further strategies are needed to maintain high accuracy levels. APPs are not effectively screening independently, indicating a need for improved PM&R consult practices.