CONTINUOUS QUALITY IMPROVEMENT

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CONTINUOUS QUALITY IMPROVEMENT THE LUMBAR SPINE
FUSION
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FACILITATOR DARRELL LEE

• OUR RESEACH ADVISOR
• DR. ANN MARIE FLORES
• THE REST OF THE TEAM
• JIMMY GILMORE
• CORY HUSTAD
• SHANE KERLIN
• NICOLE MOTZNY
• FLAVIO SILVA

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WHY DID WE CHOOSE THIS TOPIC LUMBAR FUSION
(LF)?

• LOWER BACK PAIN IS THE 1 REPORTED PHYSICAL
  AILMENT IN THE US
• VANDERBILT PERFORMED 173 LF IN 2007 (Dr. Davis
  team)
• TO CREATE A STANDARD OF CARE FOR LF AMONG
  SURGEONS AND PHYSICAL THERAPISTS
• AFTER ATTENDING A COURSE ON POST SURGICAL SPINE
• WE REALISED THAT THE PROTOCOLS WERE NOT
  BASED ON RESEARCH!
• THIS IS WHAT WE FOUND IN THE RESEARCH FOR
  EVIDENCE BASED MEDICINE (EBM)

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USC IS THE ONLY CURRENT AND ONGOING RESEARCH
THAT WE FOUND THAT WAS TRYING TO DEVELOP A LUMBAR
FUSION PROTOCOL. THIS IS NOT AN ESTABLISHED
PROTOCOL AT THIS TIME.
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OUR PURPOSE/OUR AIMS

• IN 2007-2008 WE DEVELOPED A POST-OP LUMBAR FUSION
  EXERCISE PROTOCOL
• THIS INCLUDED
• COMMUNICATING WITH THE SURGEONS/STAFF TO FIND
  SAFE THERAPEUTIC EXERCISES
• DEVELOPING A PROTOCOL TO INCLUDE BEFORE SURGERY
  (PRE-OPERATION VISIT TO PT)
• WORKING WITH ACUTE CARE REHAB
• HAVING THE PATIENT COME BACK TO OUTPATIENT PT AT
  THE VOI

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THIS YEAR WE HAVE BEEN WORKING ON IRB APPROVAL
AND ADVANCING OUR RESEARCH

• -WE ALL COMPLETED IRB CITI TRAINING
• -WE COMPLETED THE IRB APPLICATION
• -WE COMPLETED IRB APPLICATION REVISIONS
• -WE HAVE CONTINUED THE DISCUSSIONS WITH THE SPINE
  SURGICAL TEAMS

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THE SPINE PT TEAM WILL BE COLLECTING DATA
RELATED TO PATIENTS WITH LF-SF
12-OSWESTRYAT THIS POINT IN TIME THE
SURGICAL TEAMS WILL NOT BE COLLECTING THE DATA
FOR THIS STUDY
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NOW WE ARE WORKING TO COMPLETE THE IRB APPROVAL
SO THE DATA COLLECTION CAN BEGIN!
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THE FUTURE OF THE SPINE FOCUS TEAM.

• ANALYSIS OF THE DATA COLLECTED
• PUBLICATION
• CONTINUED COMMUNICATION WITH THE SURGICAL TEAMS
• REVISION OF PROTOCOL IF NEEDED
• COMPARATIVE STUDIES OF PT VS. NO PT AFTER
  SURGERY, REVISION SURGERY NUMBERS, POST-OPERATIVE
  COMPLICATION

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ANY QUESTIONS?
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• THANK YOU!