Adapting and implementing opioid-sparing pain management protocols across Mount Sinai Health System Emergency Departments - This project, Adapting and implementing opioid-sparing pain management protocols across Mount Sinai Health System Emergency Departments will permit the creation of a new systematic approach to deliver opioid-sparing pain management across Mount Sinai Health System emergency departments (EDs). Protocols will be adapted and implemented to provide opioid-sparing pain management to ED patients with these five conditions: headache/migraine, musculoskeletal pain, renal colic, chronic abdominal pain, and extremity fracture/joint dislocation. We will adapt and implement the opioid-sparing pain management protocols through a multi-step process that involves stakeholder input, adaptation of the alternatives to opioids (ALTO) pain management pathways, formation of electronic health record (EHR) order sets, training of ED medical and nursing staff on the opioid-sparing pain management protocols and order sets, implementation of the order sets, and continuous monitoring and re-evaluation of the resulting adapted pain management protocols. The project will be conducted across the Mount Sinai Health System's eight EDs in New York City, which administer medical care to over 750,000 patients annually. Mean age among patients at these eight EDs is 45 years-old; 52% are female and 48% male; 21% self-identify as Hispanic; and 26% self-identify as Black. The goals and objectives for the project are as follows: Goal 1: Adapt opioid-sparing pain management protocols for Mount Sinai Health ED patients from the ALTO pain management pathways (for headache/migraine, musculoskeletal pain, renal colic, chronic abdominal pain, and extremity fracture/joint dislocation) with the assistance of stakeholders (ED medical staff (attending physicians, fellows, resident physicians, physician assistants (PAs)) and nursing staff at Mount Sinai). Objective 1: Preparation of pain management protocols adapted from the ALTO pain management pathways Goal 2: Prepare EHR order sets for opioid-sparing pain management protocols (headache/migraine, musculoskeletal pain, renal colic, chronic abdominal pain, and extremity fracture/joint dislocation) for Mount Sinai Health EDs with the assistance of stakeholders (ED medical staff (attending physicians, fellows, resident physicians, PAs) and nursing staff at Mount Sinai. Objective 2: Preparation of EHR order sets for the opioid-sparing pain management protocols Goal 3: Train all Mount Sinai Health ED medical and nursing staff on the opioid-sparing pain management protocols (for headache/migraine, musculoskeletal pain, renal colic, chronic abdominal pain, and extremity fracture/joint dislocation) and EHR order sets and deploy them across the Mount Sinai Health EDs. Objective 3: Training of ED medical and nursing staff on opioid-sparing protocols and EHR order sets Goal 4: Evaluate process and clinical outcomes from training Mount Sinai Health ED medical and nursing staff and deployment of the implementation strategies. Objective 4: Reduction of opioid analgesia administered during the ED visit and prescribed for after the ED visit for headache/migraine, musculoskeletal pain, renal colic, chronic abdominal pain, and extremity fracture/joint dislocation
