Wednesday, April 24, 2024
4/24/2024
The Pain Assessment and Management Initiative’s Emergency Department Alternatives to Opioids (PAMI ED-ALT) project aims to increase utilization of opioid alternatives in treating ED patients’ pain. We will do so by integrating opioid alternatives (including non-pharmacologic techniques) into ED clinician’s workflow, creating a Pain Coaching and Referral service, and reinforcing our initiatives with an implementation-outcomes feedback loop. University of Florida Health Jacksonville (UFHJ) serves an urban, inner-city, and underserved patient population as our region’s safety net hospital. UFHJ’s two EDs serve over 120,000 patients per year, and we are the region’s only Level 1 Adult and Pediatric trauma center. Over half of UFHJ ED patients are African American and over 80% are on Medicaid, Medicare, or have no insurance. This project’s goals and objectives would apply to over 30,000 ED visits per year. Collectively over 3 years our efforts will impact nearly 100,000 ED patient visits and we will educate over 200 ED clinicians and staff (including resident and fellow physician trainees). Our goals and objectives build upon our existing PAMI infrastructure (https://pami.emergency.med.jax.ufl.edu/) to increase non opioid pain management alternatives, improve ED opioid stewardship and educate patients and their caregivers. PAMI ED-ALT’s first goal will prominently integrate non-opioid and non-pharmacologic alternatives into the ED electronic medical record with order panels for four common painful conditions (renal colic, musculoskeletal pain, headache/migraine, and low back pain). The creation of our ED Pain Coaching and Referral Service, our second goal, will draw upon existing relationships between ED-based pain experts, pain clinic physicians, integrative and addiction specialists, pain pharmacists and educators. That service will provide real-time coaching, consultation and opioid abuse risk and referral assessment for ED patients, as well as educate ED clinicians and staff on non-opioid and non-pharmacologic pain management techniques and discharge planning. Specific objectives related to those first two goals will increase: order panel use, ED administration of opioid alternatives, use of the Pain Coaching and Referral Service, and ED clinician/staff knowledge and capability to administer non-pharmacologic pain management techniques. Our third goal will reinforce and solidify the efforts of goals 1 and 2 into regular, sustainable ED practice through our creation of pain data pipelines to inform an implementation-outcomes feedback loop. Modeled using the Diffusion of Innovation theory to accelerate and reinforce changes in clinical behavior, our third goal’s objectives create weekly automated data reports to inform the project team’s initiatives, and monthly dashboards using modern visualization techniques. In combination, our initiatives will produce sustained and measurable changes in ED pain treatment that can be disseminated and readily transferrable to other healthcare institutions and populations.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).
