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5.12. SCI Center Outpatient and Primary Care Services

The SCI Center Outpatient Program provides the full spectrum of health care and rehabilitation needed by the SCI/D population. Every SCI Center provides an outpatient program of scheduled hours and treatment, including SCI/D primary care, unscheduled visits from patients with acute medical conditions, SCI HC, and SCI Telehealth care. NOTE: Any triage to non-SCI providers must include SCI consultation.
  1. The scope of outpatient treatment at SCI Centers is comprehensive and interdisciplinary. Services provided to a particular patient are a part of a continuum of care and integrate SCI-HC when needed.
  2. Generally, the SCI physician is able to successfully address the wide array of medical conditions associated with the care of persons with SCI/D. However, a SCI physician may generate a consultation to another discipline when the presenting problem is beyond the SCI physician's clinical skills.
    1. The consult should clearly indicate:
      1. Whether the SCI physician is seeking an advisory consultation, or a consultation in which treatment by the consultant is requested.
      2. That treatment by the consultant needs to be discussed in advance with the patient's SCI physician (the SCI physician retains the principal responsibility for the patient).
    2. Upon examination, the consultant may accept responsibility for the patient's treatment for that particular portion of care, or decline to accept the patient. In either case, the medical record reflects the course of treatment provided to the patient.
  3. If it is necessary for the patient to remain overnight, lodging capabilities for Veterans with SCI who are functionally independent need to be available on the SCI unit.

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