Implementing the PAUSE Pathway for Opioid Alternatives in the Emergency Department in a Western Ohio Hospital System - Project Name: Implementing the PAUSE Pathway for Opioid Alternatives in the Emergency Department in a Western Ohio Hospital System Applicant: Kettering Medical Center Network, 3535 Southern Blvd, Kettering, OH 45429 Clinical Project Director: Nancy Pook, MD Web site: https://www.ketteringhealth.org Kettering Medical Center will implement a project that combines reviewing and implementing the PAUSE opioid alternative pathway, calling patients post-emergency room discharge with education or access to community resources, and providing educational programs for providers about pain management, alternatives to opioids, and addressing these issues in a culturally appropriate way. Nancy Pook, MD, Clinical Project Director, developed the innovative and timely PAUSE protocol, which provides safe prescribing alternatives to opioids through a compassionate understanding of disease pathology. PAUSE is a primary pathway for clinicians to manage chronic or benign pain by “Pausing and considering alternatives to opioids.” The PAUSE program offers free reference materials for clinicians that show alternatives to opioids for common types of pain. This project intends to combine PAUSE with post-ED visit communication with patients to close the loop between ED visits for pain and patient connection with community resources for addiction treatment. Rather than contributing to the cycle of opioid addiction through inappropriate prescribing, this approach enables ED clinicians to initiate a break in the cycle and provide patients with a strong pathway to addiction recovery. The population we propose to serve are age 18 or older, who come to one of Kettering Health’s 14 emergency departments in seven counties, have any of the three identified pain areas (sprain and strains, musculoskeletal pain/not low back, or headache/including migraine) and are not excluded by a co-occurring medical or surgical disease, trauma, or active cancer. The goals of this project are: (1) Revitalize and update the PAUSE “alternatives to opioids” order set, ensure internal systems support the PAUSE pathway, and educate staff about the updated pathway and systems; (2) Using a person-centered approach, refer those served to appropriate internal and external resources through collaboration with community organizations; and (3) Through training, technical assistance and collaboration, increase knowledge and develop the abilities of Kettering Health providers and staff to identify and meet the pain management needs of those who come to its emergency departments for care. All interactions with patients will be documented in Epic, Kettering Medical Center’s electronic medical record system. Using SMART Objectives focused on activities that produce tangible and measurable results, the PAUSE pathway will develop and implement new training processes to reduce physician opioid prescription writing. Through data collection, regular staff and stakeholder meetings, and routine program assessment, Kettering Health will work diligently to continually improve the PAUSE pathway. Upon approval of SAMHSA funding, and once integrated into Kettering Medical Center’s cadre of services, the PAUSE program is projected to enroll and serve 14,816 patients each year of the grant, for a total of 44,448 patients served in three years. With its extensive experience implementing and managing projects funded by federal grants, Kettering Medical Center and Kettering Health have a rich history of collaborating with organizations in under-resourced, underserved areas to offer services and programs where they are most needed. Through its current grant projects funded through HRSA, the Ohio Board of Nursing, the Ohio Department of Higher Education, and the Ohio Department of Development, Kettering Medical Center has the capacity and knowledge to implement and sustain project activities.
