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Meeting Summary
Fri., May 31, 2024, the opening, welcome speech was given by Michael Vitale, MD MPH. This was followed by nine sessions of safety-focused content.
- Some of the featured talks included:
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- Actually, We Have Made a Lot of Strides in Patient Safety in Spine Surgery —L. Lenke
- Do Digital Intraoperative Technologies Have Potential to Improve Care? —R. Härtl
- Dealing with Patient Complications as a Young Surgeon —P. Louie
- Surgeon Well Being to Maximize Patient Safety —T. Albert
- Creating a Data-rich Environment to Support Value Based Healthcare —R. Sethi
- Highlighted papers included the following:
- Best Paper 1: Does a Delay of Surgery Due to a Multidisciplinary Screening Process Result in Neuromuscular Scoliosis Curve Progression in Complex Cerebral Palsy? —Brian Smith
- Best Paper 2: Comparison of Robotic, CT-Navigated, and Freehand Approaches of Screw Fixation in Correction of Deformity: How Have Outcomes Improved? —Samuel Ezeonu
- Best Paper 3: Does Pedicle Morphology Affect the Safety and Accuracy of Pedicle Screw Placement Using 3D Printed Guides? A 5-year Single Center Experience with 2,210 Screws Placed for Adult Spinal Deformity Reconstruction —Venu Nemani
- Rapid Fire Paper 4: Long Term Feasibility Study: Opiate Reduction Protocol for Common Outpatient Spine Procedures—A Single-Center Experience —Nicholas Eley
- For the full list of talks and papers, see the meeting's scientific program.
Throughout Safety in Spine Surgery Month—April, 2024—we shared a variety of spine surgery safety resources, including downloadable Best Practice Guidelines and top talks from previous years. A partial listing of these resources is available below.
Best Practice Guidelines:
Video Presentations:
- Panel Discussion | Using Technology to Make ORs Safer (or at Least Different)—with Brandon Carlson, MD; Roger Härtl, MD; Lawrence Lenke, MD; and Zeeshan Sardar, MD
- What Have Study Groups Taught Us About Complication Mitigation and What Strategies Are Important?—Eric Klineberg, MD
- Panel Discussion | How Do You Advocate for Teams in the Setting of Pressured Healthcare System Economics?—with Rajiv Sethi, MD; Michael Vitale MD MPH; Lawrence Lenke, MD; Eric Klineberg, MD; Han Jo Kim, MD; and Dean Chou, MD
Ever-increasing safety in spine surgery is critical. Keep the conversation going! Continue to watch for exclusive content about spine surgery safety through this website and on your preferred social platforms.
S3P Social Links:
For a more in-depth study of safety best practices and innovations, join us in New York City at the Safety in Spine Surgery Summit on May 31, 2024. Read More >
Join an expert faculty for a fresh look at optimizing safety in spine surgery! We’ll explore new topics such as:
- How Can Enabling Technologies Improve Outcomes?
- Avoiding Complications with New Techniques
Plus, bring your whole care team for discussions on:
- Building and Maintaining an Expert OR Staff
- Collaborating with the Next Generation
Find out more details and register today!
Keynote Speaker: Nick Petrie
Author, researcher, and consultant Nick Petrie specializes in leadership development for senior executives and helping organizations build a healthy, high-performance culture. Co-Author of Work Without Stress, Nick believes that performance and excellence do not have to be synonymous with burnout. Born and raised in New Zealand, he has significant international experience living and working in Japan, Spain, Scotland, Ireland, Norway, and Dubai. Past clients include Google, NASA, Walmart, Deloitte, Red Bull, Kellogg’s, Workday, Qantas and Comcast.
Nick is a proud father to four sons, and a three-time cancer survivor. He and his wife recently returned to New Zealand to raise their family in his beautiful homeland.
Browse the Safety Summit brochure and more information >
Saturday, April 15, 2023 | Location: Roy and Diana Vagelos Education Center (VEC), Columbia University, 104 Haven Ave, New York.
We invite you to join us for the 8th Annual Safety in Spine Surgery Summit. We are returning to an in-person meeting this April in New York for a one-day CME-accredited course. Safety in Spine Surgery Month will also feature video content and promotion to raise awareness and highlight S3P work and resources.
More Information
Did you catch these highlights from Safety in Spine Surgery Month, Week 3? Our April 15 webinar was packed full of practical advice on implementing checklists and guidelines, and the faculty included leaders from the SRS, the AANS, POSNA, and more. We jammed a lot of education into those 2 hours! You can catch the replay on our website here.
Since we are talking about checklists, do you know about all the free safety in spine surgery resources on the S3P website? We have risk severity scores, checklists, pathways, and more.
We also continue to post daily videos about safety from a variety of leaders across all our social media channels. I think these videos are getting better and better! This week’s videos included:
- Carlton Weatherby from Medtronic talking about their steadfast commitment to unmatched quality.
- Dr. John Smith sharing about the success he’s seen in dedicated surgical teams and checklists—they make surgery “much more efficient, safer, and fun.”
- We posted a clip from Dr. Roger Härtl’s 2020 talk about the market approval process for new technology.
- Dr. Kevin Shea told us about the POSNA Safe Surgery Program. Learn more here.
- Dr. Rick Sasso explained the No Strikeout Protocol he developed at the CSRS. This resource is free to download, too.
- Dr. Chris Hardesty shared about peri-op care protocols, which “help remove variation in practice, which can help decrease variation in outcomes.”
- Finally, we capped off the week with General Stan McChrystal, our Keynote Lecturer at the 2018 Safety in Spine Surgery Summit, sharing his thoughts on how teams impact safety.
As always, you can review all these videos, plus our library of past talks, for free on the website.
We want to thank this week’s contributors, as well as this week’s partner organizations: Medtronic, Pediatric Spine Study Group & the Pediatric Spine Foundation, POSNA, and the CSRS.
We still want to hear from you! Post safety tips or questions on your own social media—tag us, and you might win a $100 gift card! Winners are drawn each week from all social media channels.
View all this week’s videos here.
We had some amazing videos sharing the message about safety in spine surgery, with both top-level commentary as well as practical tips. This week our daily safety tip videos were seen by over 11,000 people, and our overall audience grew by 40%. Highlights included:
- Dr. Lehman asked us, “Why is it safer to fly in an airplane than to have surgery?,” in his video on Safety By the Numbers.
- Prof Carl-Eric Aubin shared about the biomechanical considerations in assessing spinal instrumentation for safety.
- Vafa Jamali from Zimmer Biomet shared about their support of the Safety month.
- Dr. Hey shared about the importance of spine surgery checklists, including a link to the downloadable checklists he’s created.
- And finally, Dr. Elowitz explained the connections between communication, patient safety, and medical malpractice.
Several of these daily tip videos are taken from longer talks presented at past Safety in Spine Surgery Summits. Did you know we have a library of these talks that you can browse & watch for free? Visit the videos tab on our website, or start here with the 2020 Safety Summit videos.
We also had over 500 people register for the April 15 webinar Checklists & Guidelines Which Make Spine Surgery Safer, which featured 4 of our Award Winners for the Best New Methodologies and Techniques to Enhance Safety in Spine Surgery, as well as a “who’s who” of surgeon leaders representing spine safety efforts from leading societies including the SRS, AANS, and POSNA.
We want to thank this week’s contributors, as well as this week’s partner organizations: NewYork-Presbyterian, Medtronic, Zimmer Biomet, NeuroPoint Alliance, Hey Clinic, and CareGuard.
We want to hear from you, too! Post safety tips or questions on your own social media—tag us, and you might win a $100 gift card! Winners are drawn each week from all social media channels.
View all this week’s videos here.
The Safety in Spine Surgery Project is pleased to announce the First Annual Safety in Spine Surgery month, taking place in April of 2021. The goal of this project is to improve safety in spine surgery by sharing guidelines, techniques, and protocols that make care better, and to share lessons learned from participants who have developed specific, successful safety protocols. This event will feature 2 live webinars and an industry-wide social media campaign throughout April.
Under the leadership of Michael G. Vitale, MD, MPH and co-chairmen John Flynn, MD; Roger Härtl, MD; Larry Lenke, MD; Rajiv Sethi, MD, S3P is partnering with surgeons, allied health care providers, organizations, hospitals, and medical device companies in this effort. It is the belief of the program directors that all major healthcare stakeholders are obligated to invest their expertise and funds to enhance patient safety.
Submission of abstracts and projects summaries is underway for Best New Methodologies and Techniques to Enhance Safety in Spine Surgery. The 10 best submissions will each be awarded $1000 and be featured during one of the live webinars. We encourage our colleagues to submit not only scientific papers, but also any project that has made a difference in spine surgery quality, safety, or value. Submissions are due to Kate Laney by February 19, 2021.
Registration is open for two live webinars, taking place April 15 and April 29. The first will focus on predictive analytics, enabling technology, and innovative techniques to make the OR safer. The second will highlight checklists, guidelines, and tricks to avoid complications and improve neurological safety. Registration is free and can be accessed at this link.
We encourage you to get involved in this effort by submitting abstracts, attending the webinars, and getting active on social media during the month of April. Post your successes and difficulties with the hashtags #safetyinspinesurgery and #s3p. Follow us on Twitter, Facebook, Linkedin, and Instagram for further information.
If your practice, organization, or medical device company would like to partner with us, please contact Kate Laney.
We are looking forward to an exciting month of collaboration!
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By Rajiv K. Sethi, Aditya V. Karhade, Michael G. Glenn and Gary S. Kaplan—
Until the Covid-19 pandemic struck, surgical patients in the U.S. had been increasingly traveling to designated Centers of Excellence, health systems that met stringent criteria for providing exceptional, high-value care for specific procedures such as knee replacement and spinal surgery. In some cases, large employers such as Walmart entered into contracts with the COE providers to care for their employees, whose travel to the specified provider for evaluation and, if needed, surgery, would be fully covered. In other cases, patients would travel from afar using other coverage to receive this specialized care.
Our institution, Virginia Mason, along with others including Geisinger, the Mayo Clinic, and Johns Hopkins are designated Centers of Excellence. Among the services patients have traveled to us for are complex spine surgeries, one of the most challenging procedures.
By shutting down most travel, the pandemic might have put an end to such programs, at least for the duration. But at Virginia Mason, prior investments in telemedicine technology for virtual patient encounters and virtual multidisciplinary perioperative clinical-team conferences have allowed us to continue providing surgery and other spine care to both local and remote patients traveling from hundreds or thousands of miles away, as well as to enhance virtual patient care broadly.
The Spine Team Approach
Based in Seattle, we were among the first organizations to confront the Covid-19 pandemic and, as such, had no blueprint to guide our response. Regulatory guidelines were constantly evolving and there were widespread shortages of personal protective equipment (PPE). Travel restrictions were keeping patients from many states away from Seattle and, fearing infection with the novel virus, local patients were deferring needed care. A ban on elective procedures resulted in precipitous and profound decreases in clinical care revenue and financial pressures were intensifying.
The pandemic forced us to quickly respond to novel clinical challenges, but we also needed to develop new ways to coordinate our sophisticated care teams and to safely engage with patients, including those traveling to Virginia Mason for complex spine surgery.
Like many leading organizations, Virginia Mason emphasizes a multidisciplinary approach to value-based care, which focuses on improving outcomes while reducing costs. The “Seattle Spine Team Approach” is a fully developed example of such comprehensive and condition-specific care. This model involves pre-surgical team conferences (now held virtually) that include orthopedic surgeons, neurosurgeons, physiatrists, pain medicine specialists, specialty-trained nurses and physician assistants, hospitalists, psychologists, and anesthesiologists. These conferences, along with the requirement that two attending surgeons are present during complex spine surgeries and the institution of a tailored intraoperative anesthesia protocol, have resulted in a three-fold reduction in major complications in the most complex spinal procedures. Many team members see these conference as the cornerstone of the entire spine care program.
When a patient is referred for spine surgery, the team holds a virtual “patient clearance” conference to evaluate whether he or she will decisively benefit from the procedure or may be as effectively treated without it. (In our prior studies of in-person visits where referred patients were presumed to need lumbar surgery, we found that 58% in fact didn’t need it.) For those patients found to be good candidates for surgery, the team conducts a risk stratification to determine which require immediate surgery and begins pre-surgical “optimization,” evaluating patients for surgical risk factors such as obesity, diabetes or smoking. In non-urgent cases, the team postpones surgery to allow time to address these.
Our clinicians have embraced the virtual conference format. We have seen increased attendance and continued engaged discussion by our clinical staff. Further, providers who rotate between clinical sites can attend these more easily than the previous physical meetings. As a result, the spine team has now committed to all-virtual patient-clearance conferences as its “new normal” and expects to continue with these virtual conferences even after restrictions on in-person meetings are lifted.
Combining Virtual and Hands-on Care
A recent case illustrates how we are integrating traditional destination care and new virtual care models. A 57-year-old man from Alaska had been experiencing progressive weakness in his arms and legs and for several weeks was unable to get timely outpatient evaluation because of the pandemic. As his symptoms became severe, his local doctor referred him to one of our physicians. The team held a virtual care conference and the same day a consultation with his local doctor, determining that the patient would require complex cervical spine reconstructive surgery. Within a day of those meetings, the patient was on a plane from Alaska to Seattle where he was scheduled to undergo immediate surgery at Virginia Mason. Two weeks later, the patient returned to Alaska and all further communication with the patient and his local doctor has been conducted virtually. Within three months after surgery, the patient had regained full use of his arms and legs and returned to work. We are continuing to follow him through serial virtual visits that include his surgeon, specialized spine physician assistants, rehab physicians and pharmacy.
While the pandemic hasn’t substantially interrupted our destination care program for patients needing urgent specialized spinal surgery, it has underscored the less dramatic, but equally important element of the program—it’s focus on identifying candidates for surgery who in fact can be effectively managed without it. It’s now clear that, going forward, many nonsurgical patients could receive a comprehensive evaluation and treatment without physically traveling to Seattle. These patients can be managed virtually by our non-operative spine specialists and continue their treatment plan without travel-related interruption. With virtual multidisciplinary care we have actually increased access to quality care while, with the decrease in required travel, dramatically reducing the costs of evaluation and treatment.
Acknowledging the terrible human suffering and financial toll of Covid-19, we anticipate some positive lasting changes. Virtual multidisciplinary conferences and telemedicine allow us to provide our model of care to all patients, not just those in COE programs. For patients back home after surgery, telemedicine allows for close and timely follow-up without the burden of travel. Virtual multidisciplinary conferences can improve care by allowing same-day, real-time assessments of the urgency of patients’ needs and facilitating immediate triage. In addition, they can serve as a consult resource for patients’ local providers. The potential silver lining of the current Covid crisis may be its role as a catalyst to enable a better paradigm of value-based care.