Quality standard

Quality statement 5: Coordinating care for adults with metastatic spinal cord compression

Quality statement 5: Coordinating care for adults with metastatic spinal cord compression

Quality statement

Adults with metastatic spinal cord compression (MSCC) have their ongoing care coordinated by an MSCC coordinator.

Rationale

The care and treatment of adults with MSCC may involve a number of specialties, including oncology, surgery and radiology. It is important that the ongoing investigations and treatments are undertaken promptly because early intervention has a positive effect on MSCC outcomes. The principal role of the MSCC coordinator for adults with MSCC is to liaise with the relevant specialists and organise treatment and any ongoing investigations, ensuring that the ongoing care of adults with MSCC is both comprehensive and timely.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

Process

Proportion of adults with MSCC whose ongoing care is coordinated by an MSCC coordinator.

Numerator – the number of adults in the denominator whose ongoing care is coordinated by an MSCC coordinator.

Denominator – the number of adults with MSCC.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records.

What the quality statement means for different audiences

Service providers ensure that an MSCC coordinator is available to coordinate the ongoing care for adults with MSCC.

Healthcare professionals ensure that they arrange access to the MSCC coordinator who will coordinate the ongoing care for adults with MSCC.

Commissioners ensure that they commission services that provide access to an MSCC coordinator who will coordinate the ongoing care for adults with MSCC.

Adults with MSCC have their treatment organised by a coordinator who will oversee important aspects of care on their behalf.

Definitions of terms used in this quality statement

MSCC coordinator

The MSCC coordinator ensures that:

  • key information about each person is recorded; this includes information on:

    • clinical presentation

    • neurological assessment

    • performance status

    • frailty assessment

    • investigations, including imaging reports

    • oncology assessment and disease staging

    • individual needs, preferences and circumstances (for example, language and communication needs)

  • initial triage of information about the person's care is performed

  • appropriate information is shared with primary care and with the multidisciplinary team

  • discharge planning is coordinated.

They provide initial advice to referring healthcare professionals on:

  • pain management

  • spinal stability

  • immobilisation

  • the use of dexamethasone

  • referral and transfer for specialist treatment.

An MSCC coordinator should be available 24 hours a day, 7 days a week, acting as a single point of contact for healthcare professionals. [Adapted from NICE's guideline on spinal metastases and metastatic spinal cord compression, recommendations 1.1.7, 1.1.15 and 1.1.16]