Preclinic Group Education Sessions Reduce Waiting Times and Costs at Public Pain Medicine Units

Davies, Stephanie; Quintner, John; Parsons, Richard; Parkitny, Luke; Knight, Paul; Forrester, Elizabeth; Roberts, Mary M.; Graham, Carl; Visser, Eric; Antill, Tracy; Packer, Tanya; Schug, Stephan A.

doi:10.1111/j.1526-4637.2010.01001.x

Cited by 65 publications

(84 citation statements)

References 40 publications

(43 reference statements)

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“…For example, although an earlier review identified limited implementation of health policy into practice for osteoarthritis in Australia, 16 this situation is slowly being redressed with the introduction of MoCs, in this context particularly through the NSW MoC for osteoarthritis and WA MoC for Elective Joint Replacement (Table 1). Further, although the wait to access pain medicine services in Australia has been protracted for consumers, 17 timely access has been dramatically improved in WA owing to the introduction of a system-oriented MoC for pain services, 18 introduced in parallel with initiatives to build workforce and consumer capacity to better manage musculoskeletal pain syndromes. [19][20][21][22][23] A recent audit in WA identified positive uptake of all disease-group MoCs across the WA Health Services, particularly with respect to awareness and service planning, yet responders identified that sustainable implementation efforts were stymied by lack of resources to sustainably support implementation efforts.…”

Section: Models Of Care: Do They Make a Difference?mentioning

confidence: 99%

Models of care for musculoskeletal health in Australia: now more than ever to drive evidence into health policy and practice

Briggs¹,

Towler²,

Speerin³

et al. 2014

Aust. Health Review

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Abstract.Musculoskeletal health conditions such as arthritis, osteoporosis and pain syndromes impart a profound socioeconomic burden worldwide, particularly in developed nations such as Australia. Despite the identified burden, substantial evidence-practice and care disparity gaps remain in service delivery and access that limit the potential for improved consumer outcomes and system efficiencies. Addressing these gaps requires a whole-of-sector response, supported by evidence-informed health policy. Models of care (MoCs) serve as a policy vehicle to embed evidence into health policy and guide practice through changes in service delivery systems and clinician behaviour. In Australia, MoCs for musculoskeletal health have been developed by networks of multidisciplinary stakeholders and are incrementally being implemented across health services, facilitated by dedicated policy units and clinical champions. A web of evidence is now emerging to support this approach to driving evidence into health policy and practice. Understanding the vernacular of MoCs and the development and implementation of MoCs is important to embracing this approach to health policy.What is known about the topic? The impact of musculoskeletal health conditions is profound. As the awareness around the magnitude of the impact of these conditions increases, the importance of system-wide policy responses and platforms for health service improvements is now recognised. The term 'models of care' is not new. It has been used for many years, mainly at the hospital level, for planning and delivering clinical services. However, over the past 8 years an alternative approach using health networks has been adopted for the development and implementation of models of care to achieve broad engagement and a wider and more sustainable scope for implementation. What does this paper add? Here, we provide a rationale for the development of models of care for musculoskeletal health and draw on experience in their development and implementation using a health network model, referring to an emerging web of evidence to support this approach. We describe what models of care are, how they are developed and question whether they make a difference and what the future may hold. What are the implications for practitioners? All indications suggest that models of care are here to stay. Therefore, this paper provides practitioners with a contemporary overview of models of care in Australia, their relevance to musculoskeletal healthcare, particularly related to closing evidence-practice gaps, and opportunities for sector engagement.

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Section: Models Of Care: Do They Make a Difference?mentioning

confidence: 99%

Models of care for musculoskeletal health in Australia: now more than ever to drive evidence into health policy and practice

Briggs¹,

Towler²,

Speerin³

et al. 2014

Aust. Health Review

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“…Using a system inversion MoSD, aligned with an MoC in Western Australia, inter-professional consumer group education sessions delivered prior to face-to-face practitioner appointments have resulted in significantly reduced wait-times and costs at public pain medicine units [22]. Further, consumer use of active pain self-management strategies increased with fewer requiring individual consultations.…”

Section: Health System Inversion As An Implementation Enablermentioning

confidence: 99%

“…Further, consumer use of active pain self-management strategies increased with fewer requiring individual consultations. This MoSD is recurrently resourced and has now been adopted in a number of primary care sites throughout Australia [22].…”

Section: Health System Inversion As An Implementation Enablermentioning

confidence: 99%

“…Yet, reliable data indicate that the burden of pain associated with musculoskeletal conditions can be substantially reduced when available evidence-based management is implemented [1]. Furthermore, such care is associated with measurable downstream health and economic benefits [7,22]. In order to deliver integrated MoSDs that support person-centered care an appropriately skilled health workforce is required.…”

Section: Commentary Slater and Briggsmentioning

confidence: 99%

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Models of Care For Musculoskeletal Pain Conditions: Driving Change to Improve Outcomes

Slater

Briggs

2017

Pain Manag.

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Keywords• implementation • models of care • pain management musculoskeletal pain & models of care Managing musculoskeletal pain can be challenging at a health systems level, at a service delivery level, at a clinical level and for the consumer experiencing pain. Approaching this complexity to both facilitate person-centered care and respond to the burden associated with musculoskeletal pain in an efficient, effective and sustainable way, requires reform reaching across policy and into clinical practice. In this context, Models of Care (MoCs) are increasingly regarded as a system-level enabler to translate evidence for 'what works' from policy/ systems, across service delivery and into practice. MoCs provide a platform for a reform agenda in health systems by describing not only what care to deliver but also 'how to' deliver care. We have previously comprehensively reviewed the evidence for musculoskeletal MoCs [1]. In the following commentary, rather than a focus on MoCs per se, we use working examples to show how the implementation of musculoskeletal pain MoCs is being enabled to support reform agendas. We make an explicit distinction between a MoC which provides principle-level guidance on what care to deliver and how to implement it, and a Model of Service Delivery (MoSD) which operationalizes these principles into local activity, informed by an implementation plan [2].

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“…A growing trend in healthcare, owing to spiralling costs and the shortage of providers, is an emphasis on self-management strategies or group education sessions for patients with chronic medical conditions 12,13 . This is very different from the traditional treatment model centred around doctor/patient clinic visits.…”

Section: Current Treatment Of Chronic Painmentioning

confidence: 99%

Make a CHANGE: optimising communication and pain management decisions

Müller-Schwefe

Jaksch

Morlion

et al. 2011

Current Medical Research and Opinion

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c i a l D i s t r i b u t i o n U n a u t h o r i z e d u s e p r o h i b i t e d . A u t h o r i s e d u s e r s c a n d o w n l o a d , d i s p l a y , v i e w a n d p r i n t a s i n g l e c o p y f o r p e r s o n a l u s eCurrent Medical Research & Opinion Vol. 27, No. 2, 2011, 481-488 Eli AlonUniversita¨tsspital Zurich, Switzerland Beverly CollettThe Pain Management Service, University Hospitals of Leicester, UK Dominic AldingtonChurchill Hospital, Oxford, UK AbstractThe major objectives of the CHANGE PAIN International Advisory Board are to enhance understanding of chronic pain and to develop strategies for improving pain management. At its second meeting, in November 2009, evidence was presented that around one person in five in Europe and the USA experiences chronic pain, and the delay before referral to a pain specialist is often several years. Moreover, physicians' pharmacological approach to chronic pain is inconsistent, as evidenced by the huge variation in treatment between different European countries. It was agreed that efficient communication between physician and patient is essential for effective pain management, and that efficacy/side-effect balance is a key factor in choosing an analgesic agent. The multifactorial nature of chronic pain produces various physical and psychological symptoms, so the management of chronic pain should be tailored to the individual. Pharmacological therapy must be matched to the causative mechanisms responsible, or it is likely to prove ineffective and risk the development of a 'vicious circle'; doses are increased because of inadequate pain relief, but this increases side-effects so doses are reduced, pain relief is then inadequate, so doses are increased, and so on. Pain management decisions should not therefore be based solely on the severity of pain. Based on the concept of individual treatment targets (ITT), the CHANGE PAIN Scale was adopted -a simple, user-friendly assessment tool to improve communication between physician and patient. The 11-point NRS enables the patient to rate the current pain intensity and to set a realistic individual target level. On the reverse are six key parameters affecting the patient's quality of life; clinicians simply need to agree with patients whether improvement is needed in each one. Regular use can establish the efficacy and tolerability of pain management, and the rate of progress towards individual treatment targets.

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Preclinic Group Education Sessions Reduce Waiting Times and Costs at Public Pain Medicine Units

Abstract: The introduction of STEPS was associated with reduced wait-times and costs at public pain medicine units and increased both the use of active pain management strategies and patient satisfaction.

Cited by 65 publications

References 40 publications

Models of care for musculoskeletal health in Australia: now more than ever to drive evidence into health policy and practice

Models of care for musculoskeletal health in Australia: now more than ever to drive evidence into health policy and practice

Models of Care For Musculoskeletal Pain Conditions: Driving Change to Improve Outcomes

Make a CHANGE: optimising communication and pain management decisions

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