Day surgery unit for anterior cervical spine surgery

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Eric M Massicotte

University of Toronto, Canada

: J Spine Neurosurg

Abstract

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Rising cost of health care in most jurisdictions has resulted in physician-lead innovations for more cost-effective health services. One area is to shorten the length of stay. In our effort to contain the cost of providing surgery in a public system, we looked at the efficacy of performing anterior cervical surgery for patients in our day-surgery unit (DSU). Retrospective review of prospectively collected data from 2008 to present was conducted. Data focused on surgical details, demographic, patient reported outcome and safety. Approximately 144 cases were completed between June 2008 and present day. Overall 48% were single level anterior cervical discectomy and instrumented fusion, two levels an additional 38% and three levels represented 14%. Gradual increase in the percentage of more multi-level cases was seen in the first four years. The 30-day re-admission rate was below 3%. The conversion rate from DSU to admission is currently being reviewed. Efforts for more cost-effective health care should not be at the cost of compromising patient safety. By reporting our institutional experience, a comprehensive process spanning the entire episode of care for patients undergoing anterior cervical spine surgery, we hope to demonstrate not only the safety but efficiencies. Development of a process, which includes education of not only the patients but also the entire health care team, has been vital. Each component of this process allows for maintenance of safety and ensures delivery of health service with greater patient satisfaction and uncompromising outcomes.

Biography

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Eric M Massicotte has focused his academic neurosurgical career in Toronto since his faculty appointment in 2002. As an Associate Professor with the University of Toronto, he recently completed an MBA to further advance his role as Medical Director for two programs, Back & Neck and Concussion at Altum Health a division of University Health Network (UHN). The Concussion program was an innovation started in collaboration with Dr Charles Tator.