Saturday, April 27, 2024
4/27/2024
Abstract: The Eskenazi Health Emergency Department Alternatives to Opioids Program Opiates have historically played a critical role in the response to pain management. However, the overuse of these drugs has launched the country into a state of abuse and addiction as well as an opioid overdose epidemic. The emergency department (ED) is a location commonly accessed for pain management making this an ideal location to implement approaches to reduce pain without the use of opiates. A 2018 article in the Advance Journal of Emergency Medicine2 reported 80% of admissions were due to reports of pain. As pain can be an indicator of a potential medical issue or one of the symptoms of a known medical diagnosis, emergency attention may be imperative. Assessing pain differs for each person evaluated as pain tolerance is unique and not generalizable. The Eskenazi Health Emergency Department Alternatives to Opioids program plans to create a pathway for pain management strategies using interventions such as mind-body medicine and non-opioid analgesics. This pathway will assess the medical condition of the patient and the level of pain. These methods will replace the use of opioids for pain management among populations that typically experience pain from their medical diagnosis and prevent exposure to opiates. This deterrence would then divert opportunities for opioid misuse that could potentially escalate to an opioid use disorder (OUD) and provide an alternative form of pain management for those who already struggle with OUD. Eligible medical conditions include, but are not limited to Sickle Cell Disease, gallstones, kidney disease, headaches, fractures, sprains, strains, and other medical conditions, as appropriate. Staff trained in alternative treatments will consult the pathway and determine the implementation strategy. Pharmacological interventions will be implemented by medical staff approved to apply this method of treatment, and a Pharmacy Specialist will consult and provide oversight to pharmacological intervention. Mind-body medicine will facilitate interventions such as guided imagery, music therapy, breathing exercises, and other methods that can also be replicated outside of the ED. In the case of chronic pain, patients will receive referrals to the Eskenazi Health Pain Management Clinic where they will receive pain management education, therapy, and treatment. Through these interventions, the Eskenazi Health Emergency Department Alternatives to Opioids program plans to serve 3,600 unduplicated clients for the duration of the three-year grant period. Goal 1: Project Director will collaborate with ED leadership to identify “baseline” guidance for determining which ED patients are eligible for alternative pain management within the first four months of the program. Goal 2: Implement patient-centered and team-based alternative approaches (e.g., Mindfulness training, Pain Management Clinic, MOUD) in the Eskenazi Health (EH) ED that may assist in pain management without the use of opioids within the first four months of the project, and a minimum of annually thereafter. Goal 3: Project Director and OPOC will implement patient-centered alternative pain treatment strategies, respectful of general ED processes and needs, in the EH ED within the first four months of the project. Goal 4: The Pain Management Clinic provider will implement patient-centered alternative treatment strategies based on regular pain assessments to patients in chronic pain. Goal 5: The Project Director and OPOC will evaluate the alternative pain management modalities implemented to determine the impact of the program on opioid use, and opioid-related morbidity and mortality, monthly.
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).
