Implementation of a Multidisciplinary Collaboration for the Management of Spinal Cord Ischemia

Spinal Cord Ischemia (SCI) is a devastating complication associated with major aortic coverage during the treatment of complex aortopathies. The project is designed to improve education, prevention, identification, and treatment of spinal cord ischemia at a single academic hospital. The authors have identified that despite an institutional protocol, there is continued confusion regarding its utilization and applicability for patients at risk of SCI. The authors propose an updated set of educational and action-based guidelines to improve the adherence to and active treatment of spinal cord ischemia. Methods: Using Plan-Do-Study-Act (PDSA) quality improvement methodology, a multidisciplinary team was created to identify ways to improve education and compliance for the treatment of spinal cord ischemia. The team reviewed current policies, guidelines, and order sets related to pre- and post- procedure assessments. Comparison will be performed of pre-intervention and post-implementation surveys including both likert scale and open-ended questions. Results: Pre-implementation and post-implementation surveys have been developed to better characterize the knowledge, utilization, and understanding in a single institution's treatment of spinal cord ischemia. Exploration of outliers were reviewed by the quality improvement project investigators in a positive feedback loop to continue improving the quality improvement project. Conclusion: Improvement in the management of patients at high risk for spinal cord ischemia is possible using the PDSA methodology. There has been initial success in the unification in treatment for SCI in the departments of anesthesia, cardiothoracic surgery, intensive care, vascular surgery, and nursing.