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Using Lean Six Sigma Methods to Develop an Efficient and Sustainable Interdisciplinary Team Program for Chronic Pain in a VA: PREVAIL Interdisciplinary Team Track.

作者信息

Courtney Rena E, Schadegg Mary J, Hicks Natalie, Truitt Melissa, Bolton Rendelle E, Dezzutti Brian, Cannizzo Francis, Darnall Beth D, Radatz Marilyn, Harden Samantha M

机构信息

PREVAIL Center for Chronic Pain, Salem VA Health Care System, Salem, VA, USA.

Department of Psychiatry and Behavioral Medicine, Virginia Tech Carilion School of Medicine, Blacksburg, VA, USA.

出版信息

Glob Adv Integr Med Health. 2024 Oct 13;13:27536130241290798. doi: 10.1177/27536130241290798. eCollection 2024 Jan-Dec.


DOI:10.1177/27536130241290798
PMID:39483953
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11526189/
Abstract

BACKGROUND: Chronic pain is highly prevalent in US military Veterans, and pain interdisciplinary teams (IDTs) are the gold standard in pain care. There is no standard or guidance for how best to develop and implement pain interdisciplinary teams within complex health care systems. OBJECTIVES: The purpose of this quality improvement project was to evaluate the effectiveness of the standard 9-step Lean 6 Sigma (LSS) methodology in redesigning a pre-existing VA outpatient pain clinic solely offering interventional pain services into an efficient, sustainable pain IDT program. METHODS: The initial evaluation process at a VA Medical Center that primarily serves rural Veterans was redesigned with the a priori goal of developing an efficient, sustainable IDT program that decreased driving days (ie, in-person appointments) required for a comprehensive initial pain evaluation, decreased number of consults required for initial pain evaluations, increased the number of consults to Whole Health services, and increased compliance with policies and standards. Feedback from administrators, clinicians, and Veterans was used to identify inefficiencies then iteratively design, test, and finalize a redesigned service called the PREVAIL Interdisciplinary Team Track (PREVAIL IDT Track). Baseline data was collected for 1 year followed by sustainment data for 14 months. Results were analyzed using descriptive statistics. RESULTS: PREVAIL IDT Track decreased the number of in-person appointments from 5 to 2, decreased consults required for evaluations from 5 to 1, increased the number of unique consults to Whole Health education classes, and made the VA fully compliant with policies and standards. To date, 486 Veterans have participated in the redesigned program, including 167 graduates and 212 current enrollees in this sustained clinical program. CONCLUSION: The success of PREVAIL IDT Track suggests that LSS may be a promising method for redesigning sustainable pain IDTs in VA that improve efficiency.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dff/11526189/221a10cad39e/10.1177_27536130241290798-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dff/11526189/c77954909cc1/10.1177_27536130241290798-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dff/11526189/221a10cad39e/10.1177_27536130241290798-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dff/11526189/c77954909cc1/10.1177_27536130241290798-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dff/11526189/221a10cad39e/10.1177_27536130241290798-fig2.jpg

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[1]
Using Lean Six Sigma Methods to Develop an Efficient and Sustainable Interdisciplinary Team Program for Chronic Pain in a VA: PREVAIL Interdisciplinary Team Track.

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Advances in Neurological Pain Management: Bridging Scientific Innovations and Clinical Practice.

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Using a Whole Health Approach to Build Biopsychosocial-Spiritual Personal Health Plans for Veterans with Chronic Pain.

Pain Manag Nurs. 2024-2

[2]
Innovative treatment formats, technologies, and clinician trainings that improve access to behavioral pain treatment for youth and adults.

Front Pain Res (Lausanne). 2023-7-20

[3]
Integration of Health Coaches in a Whole Health Team Model of Chronic Pain Care: a Qualitative Study.

J Gen Intern Med. 2023-12

[4]
VHA Whole Health Services and Complementary and Integrative Health Therapies: a Gateway to Evidence-Based Mental Health Treatment.

J Gen Intern Med. 2023-11

[5]
Chronic, Noncancer Pain Care in the Veterans Administration: Current Trends and Future Directions.

Anesthesiol Clin. 2023-6

[6]
Estimated Rates of Incident and Persistent Chronic Pain Among US Adults, 2019-2020.

JAMA Netw Open. 2023-5-1

[7]
Utilization of Whole Health and Longitudinal Outcomes After Screening Positive for Possible Depression Documented in Veterans Health Administration's Electronic Health Record.

J Integr Complement Med. 2023-12

[8]
Reflections on 10 years of effectiveness-implementation hybrid studies.

Front Health Serv. 2022-12-8

[9]
The Use of Opioids in the Management of Chronic Pain: Synopsis of the 2022 Updated U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline.

Ann Intern Med. 2023-3

[10]
Overcoming Barriers to the Implementation of Integrated Musculoskeletal Pain Management Programs: A Multi-Stakeholder Qualitative Study.

J Pain. 2023-5

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