The spine access team triages incoming referrals using protocols developed by Penn’s multidisciplinary spine care committee, which is led by the neuroscience service line. Penn secured buy-in for centralized triage by including clinicians from across the spine care continuum on the committee.
Departments involved in setting Penn’s triage protocols
- Physical medicine & rehabilitation
- Orthopedic surgery
- Anesthesia/pain management
- Primary care
- Social work
- Physical therapy
The committee meets monthly to review performance data from the updated EHR system, which it uses to inform further care standardization efforts. Leaders also use this data to distribute quarterly appointment volume by specialty, which keeps the broader spine network involved and prevents internal competition for volume. Regular data sharing helps reinforce a “one team” mentality across specialty groups that Penn believes will drive a more coordinated care continuum.
Comprehensive triage ensures timely, appropriate appointments
Incoming referrals flow through the spine access team, which leads triage and patient outreach using the committee-designed protocols. The team is led by a nurse navigator with a background in neuroscience and a master’s in health care leadership. This gives the team the clinical experience to triage appropriately and the operational ability to do so efficiently.
To triage patients, the team first considers referring physicians’ specialist recommendation, sending all referrals to the requested specialist. When a consult order does not request a specific specialist, the team considers the referring physician’s advice on type of care (surgical, injection, etc.) and the patient’s chart to land on the appropriate specialty. It then uses an Epic questionnaire to secure more information from patients and referring providers. This questionnaire asks about the location of the patient’s back pain and whether they’ve previously had spine care, among other things, to decide which specialist best suits the patient’s needs.
For cases requiring clinical input beyond the spine access team’s expertise, the team’s clinical manager seeks input from physicians and advanced practice providers designated to support the process.
Rapid outreach drives satisfaction for patients and referring providers
Once the spine access team reaches a decision, it contacts the patient within 48 hours to schedule their appointment, aiming to meet the patient’s needs in one call. The team also closes the referral loop by contacting the referring physician.
Ultimately, non-emergent patients have final say in choosing a provider, location, and time frame. This is a major change from Penn’s old model, in which patients could visit only the provider they called directly. Opening scheduling to all relevant providers and locations has helped shorten wait times.