Table 1

Study outcomes as defined by the four domains of the Victorian Innovation Reform Impact Assessment Framework (VIRIAF) and the data sources and collection methods used

VIRIAF domainsOutcomesData sources and collection methods*
Access to care
  • Patients receive timely access to expert management of low back and neck pain.

  • Patients receive convenient access to services within their local community.

  • Patients receive timely access to specialist surgical, rheumatology, chronic pain management and allied health services where indicated through newly developed and streamlined referral pathways of care.

  • Clinic audit.

  • Patient survey and interview.

  • Referrer survey and interview.

  • Stakeholder interview.

Appropriate and safe care
  • Patients with back or neck pain are directed to the most appropriate clinical service, including appropriate non-surgical management for those who either do not require or are unlikely to benefit from spinal surgery.

  • Patients redirected from neurosurgery, orthopaedic spinal, rheumatology and pain services experience no adverse outcomes.

  • Patients receive appropriate clinical services based on need and clinical evidence.

  • Patients experience continuity of care.

  • Clinic and triage audit.

  • Audit of hospital administrative data.

  • Patient survey and interview.

  • Referrer survey and interview.

  • Stakeholder interview.

  • Clinician survey and interview.

Workforce optimisation and integration
  • Service development and delivery involves multidisciplinary and cross-organisational collaboration, which also contributes to ongoing knowledge and skill development.

  • Surgeon time and skills are optimised towards assessing and managing patients with back or neck problems that are more likely to benefit from surgery and for conditions that are more time critical.

  • Advanced practice physiotherapist’s and rheumatologist’s skills are optimally used to assess and manage patients with back and neck pain.

  • The community health workforce capacity is expanded to include management of more complex patients with back and neck pain.

  • Clinician survey and interview.

  • Referrer survey and interview.

  • Stakeholder interview.

  • Patient survey and interview.

Efficiency and sustainability
  • Cost-effective management of patients with low back or neck pain is demonstrated.

  • Service replicability and sustainability are demonstrated.

  • Clinic and triage audit.

  • Audit of hospital administrative data.

  • Clinician survey and interview.

  • Stakeholder interview.

  • Use of MRIs and CTs.

  • *Apart from the collection of patient surveys, which was conducted during the BAC pilot, all other data collection was performed at the conclusion of the 12-month pilot project.