The Spinal Cord System of Care Programme
The National Spinal Cord Injury Service operates between the Mater Misericordiae University Hospital (Mater) and the National Rehabilitation Hospital (NRH). This service provides comprehensive care for patients with spinal cord injury from the acute episode through to their return to the community. For the majority of patients, this will be followed by a life long outpatient service at NRH.
The service admits patients with spinal cord injury from throughout the country, and also Irish nationals injured abroad who require ongoing treatment and care for their injury.
The Spinal Cord System of Care Programme at the NRH provides comprehensive inpatient and outpatient services to patients who, as a result of an accident, illness or injury, have acquired a spinal cord injury, or spinal cord dysfunction, and who require specialist medical rehabilitation.
Spinal cord dysfunction may result from traumatic injury or non-traumatic injury including such disorders as benign or malignant spinal cord tumours, demyelination, vascular or inflammatory disorders.
The SCSC Programme also includes the management of patients with peripheral neuropathies, such as Guillain Barré Syndrome, as similar principles of rehabilitation apply to these conditions.
Following a traumatic spinal cord injury, many patients are first transferred by the local medical service to the Department of Orthopaedics in the Mater Hospital National Spinal Injuries Unit . It is in keeping with international best practice that patients who sustain a traumatic spinal injury are treated in a designated spinal injuries unit.
Early assessment and treatment is carried out in the Mater and the Rehabilitation Medicine Consultant service from the NRH follows the patients’ progress there. Patients considered suitable for inpatient rehabilitation are transferred to the NRH as soon as possible. This ensures continuity of care for the patient, from both orthopaedic and rehabilitation medicine.
Patients who have sustained a non-traumatic spinal cord injury and have been managed in acute hospitals all over the country are admitted directly to the National Rehabilitation Hospital. They may have had early input from our Spinal Cord Injury Liaison Service.
The SCSC Programme Rehabilitation Teams
The Spinal Cord System of Care (SCSC) Programme at the NRH has developed a continuum of care for people with spinal cord dysfunction, encompassing the inpatient rehabilitation phase, outpatient phase and links to community services. This continuum of care ensures that all individuals can receive the most appropriate programme of care based on their injury and their individual rehabilitation needs. The Spinal Injury Team recognises that there is an ever increasing emphasis on the patient perspective in all aspects of their health care.
The rehabilitation teams within the Spinal Cord System of Care Programme provide specialised rehabilitation treatment and care, designed to assist people with Spinal Cord Injury, and their families / carers, to:
- Adjust to their injury and manage their impairment
- Achieve the safest possible level of physical independence
- Promote greater levels of functional independence
- Participate maximally in their home, community & social lives
The rehabilitation teams work together with patients and their families and carers to achieve the best possible outcome from the Rehabilitation Programme, which is tailored to meet each patient’s individual needs.
- Patient care and treatment for the Spinal Cord System of Care Programme is delivered by interdisciplinary teams, with clinical responsibility led by Dr. Éimear Smith (Medical Director for the SCSC Programme)
- Dr. Smith also provides a service to National Spinal Injury Unit at the Mater Hospital Dublin.
- Dr. Cara McDonagh, Consultant in Rehabilitation Medicine also provides a consultant service to the SCSC Programme at the NRH.
- The SCSC Programme Manager is Eugene Roe
The NRH is one of the largest rehabilitation hospitals in Europe. A programme to increase the number of Consultants in Rehabilitation Medicine, in line with International best practice, is being actively pursued.
At NRH, the Spinal Injury Service accesses the full complement of support from:
- Nursing and clinical support
- Therapy services
- Patient Services (administration)
The SCSC Programme is well supported by a number of visiting consultants from Radiology, Urology, Orthopaedics, Plastic Surgery, Psychiatry, Anaesthetics, Microbiology and Dentistry.
The programme aims to discharge all patients after they have achieved their desired rehabilitation goals and have received maximum benefit from the programme.
Referrals to the SCSC Programme
The majority of patients admitted to the service come from the National Spinal Injuries Unit in the Mater Hospital. Patients are also accepted from other hospitals throughout the country and must be referred either by the Consultant at their referring hospital or their GP.
Improving the quality of patient treatment and improving access for patients on the waiting list is of the highest priority at the NRH.