A 2-year retrospective study of data from a Regional Spine Centre to evaluate staff and patients compliance regarding data entry to the British Spinal Registry
Emily Tsang, Lupu C, Fragkakis A, Bernard J, Bishop T and Lui D
St George’s University Hospital NHS Trust, UK
: J Spine Neurosurg
Abstract
Introduction: The British Spinal Registry (BSR) is a web-based database commissioned by the British Association of Spine Surgeons (BASS) in the UK. It allows auditing of spinal surgery outcomes, patient safety, and overall experience. The clinical data include patient demographics which is entered into the Registry by medical staff, as well as Patient-Reported Outcome Measures (PROM) that is submitted to the Registry by the patient themselves at different time periods postoperatively. It has the ability to register Devices and Implants as well as coordinate multicentre research. This study is to identify both the staff and patient compliance regarding data submissions to the BSR at St. George’s Hospital NHS Trust. Methods and Materials: Retrospective analysis of the BSR data for all spinal surgeries that were performed at SGH by the three Complex Spinal Surgery Consultants between 1st January 2017 to 31st December 2018. This study period allowed up to 12 months of PROM data analysis. Staff and Patient compliance were analyzed separately depending on the data they submitted. Result: 404 (n) spinal surgeries were performed over this two-year period. Surgical demographics: 39.4% (159/404) males and 56.2% (227/404) females, 4.5% (18/404) declined to be added. Age ranging from 6 to 92, mean age was 47.9. Staff compliance was 89.4% for the registration of patient data. Trauma and tumour patients were excluded as they are not required to complete any pre-operative PROMs. For the remaining patients, 35.8% (116/324) completed their baseline pre-operative PROMs. A steady decrease in patient compliance for post-operative PROMS was observed: 29.8% (2 weeks), 24.9% (6 weeks), 21.2% (6 months), 17.1% (12 months), and 16.6% (24 months). Conclusion: We identified poor patient compliance in both pre-operative and post-operative PROMS. Patient questionnaire fatigue can occur over time which results in falling compliance to PROMS in 12 months and 24 months. Moreover, patients who do not provide an email address are less likely to fill in their PROMS. Satisfactory compliance for staff regarding BSR utilization is shown. Staff should aim to achieve a higher level of compliance as this will help to keep a record of all spinal surgeries that are performed and any complications that are encountered in a particular center. Over the past three years, the BSR had introduced various schemes to drive up utilization including a Best Practice Tariff in 2019. Part of the tariff will be withheld when staff failure to enter patients onto the Registry. Further research is needed to determine why there is such falling off especially with patient compliance and to elucidate potential measures to improve their compliance.
Biography
Emily Tsang is a fifth-year medical student from St. George’s, University of London. She has been working with the spinal team at St. George’s University Hospital for several years on different projects.
