PP312 – Transitional Pain Service
Many surgical interventions introduce or increase opioids as routine pain management post-surgery. Opioid naïve patients have up to a 14% risk of developing new chronic opioid use and continuing on opioids long-term and rural patients have greater challenges in obtaining treatment for CPSP and pain management once they leave the tertiary center area post-discharge. Post-operative pain is typically managed by the surgical team for 2-6 weeks after surgery with the primary care provider (PCP) assuming responsibility once the surgeon declares surgical follow-up complete. This practice pattern often leads to poor pain control with unnecessary and preventable ER visits for pain, uncertainty by the PCP regarding the expected course of recovery from surgery, and inappropriate and prolonged opioid therapy. Salt Lake City VA has developed a successful Transitional Pain Service (TPS), that incorporates patient-centered perioperative pain management and care coordination. This innovative pilot has incorporated recommendations VA/DOD Clinical Practice Guidelines for Chronic Opioid Use, American Pain Society, Patient-centered Outcomes, and integrates the concepts of a peri-operative surgical home with personalized nursing care coordination. This multidisciplinary program relies upon a clinical decision support tool that: 1. Provides patient tracking, 2. Allows communication between providers in the program, 3. Summarizes key clinical parameter’s, allowing for better clinical decision making.