Economics of Acute Pain Medicine

2019 ◽  
pp. 10-22
Author(s):  
Brian E. Harrington ◽  
Edward R. Mariano
Keyword(s):  
Program Development ◽  
Acute Pain ◽  
Quality Care ◽  
Multimodal Analgesia ◽  
The United States ◽  
Pain Medicine ◽  
Future Directions ◽  
Healthcare Settings ◽  
Core Concepts ◽  
Economic Considerations

Appropriate resource allocation is vital for the successful delivery of acute pain medicine services. This chapter describes core concepts in acute pain medicine (such as use of multimodal analgesia and pain protocols) and reviews the economic considerations regarding acute pain medicine program development and implementation, including consideration of value-based models that are intended to promote efficient, high-quality care at a lower cost. Notably, while many of the principles may be universally applicable, the underlying context regards deployment of acute pain medicine programs within healthcare settings in the United States. The chapter concludes with a section on future directions in acute pain medicine.

Acute Pain Medicine

2019 ◽  
Keyword(s):  
Acute Pain ◽  
Treatment Options ◽  
Multimodal Analgesia ◽  
Anesthetic Techniques ◽  
Pharmacologic Treatment ◽  
Large Array ◽  
Pain Medicine ◽  
Regional Anesthetic

Acute Pain Medicine tackles a large array of diagnostic and treatment consideration across a variety of surgical and nonsurgical acute pain conditions. It reviews a variety of acute pain–modulating factors followed by interventional and pharmacologic treatment options. For each applicable condition, perineural and neuraxial considerations are given when appropriate along with nociceptive anatomic complements. Pharmacologic modalities are described, stressing the use of multimodal analgesia and a variety of opioid-based options if necessary. The book reviews cases that commonly are associated with significant acute pain but also highlight the role of acute pain medicine physicians in the postdischarge phase. Finally, the book includes a critical update of the Military Advanced Regional Anesthesia and Analgesia handbook. This update serves as an essential bedside tool in the performance of regional anesthetic techniques and their corresponding anatomic considerations.

scholarly journals Economic Considerations of Acute Pain Medicine Programs

2017 ◽  
Vol 32 (4) ◽  
pp. 217-225 ◽  
Author(s):  
Chancellor F. Gray ◽  
Cameron R. Smith ◽  
Yury Zasimovich ◽  
Patrick J. Tighe
Keyword(s):  
Acute Pain ◽  
Pain Medicine ◽  
Economic Considerations

scholarly journals Acute Pain Medicine in the United States: A Status Report

Pain Medicine ◽  
2015 ◽  
Vol 16 (9) ◽  
pp. 1806-1826 ◽  
Author(s):  
Patrick Tighe ◽  
Chester C. Buckenmaier ◽  
Andre P. Boezaart ◽  
Daniel B. Carr ◽  
Laura L. Clark ◽  
...  
Keyword(s):  
United States ◽  
Acute Pain ◽  
The United States ◽  
Status Report ◽  
Pain Medicine

scholarly journals A review of patient safety communication in multicultural and multilingual healthcare settings with special attention to the U.S. and Canada

2021 ◽  
Author(s):  
Á. Horváth ◽  
P. Molnár
Keyword(s):  
Patient Safety ◽  
Adverse Events ◽  
Quality Care ◽  
National Level ◽  
Healthcare Providers ◽  
Language Barriers ◽  
Effective Communication ◽  
The United States ◽  
Safety Communication ◽  
Healthcare Settings

Abstract Purpose The present work aims to raise awareness of the issue of patient safety communication in multicultural and multilingual healthcare settings and to present strategies on how to overcome emerging cultural and language barriers and enable healthcare providers to reduce the risk of miscommunication, prevent inequalities and disparities, and provide their patients with safe and quality care. It also strives to present the policies and measures the United States and Canada have implemented and the strategies U.S. experts have developed to advance effective communication between provider and patient. Methods The literature review was conducted on academic works and publications by health associations, institutes of health, and government departments in topics such as adverse events in health care and strategies to reduce cross-cultural miscommunications and on guides for hospitals. Results/Discussion Cultural diversity in a patient population, language barriers, and a lack of effective communication can impose an increased threat on an individual's health. In order to radically decrease the incidence of adverse events, policies and systems on how to manage multinational and multilingual medical environments should be created at a national level. Cultural competence is also key to delivering care that meets patients' social and cultural needs; furthermore, developing a language access plan and providing language assistance (interpretation, translation) for those in need can greatly contribute to providing quality care. Conclusions Clear communication is key to quality care and patient safety in multicultural and multilingual healthcare environments, but to significantly reduce the incidence of adverse events, policies and systems should be created at a national level.

Formulating another’s report of troubles in peer support

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Christopher Pudlinski
Keyword(s):  
Mental Health ◽  
United States ◽  
Community Mental Health ◽  
Conversation Analysis ◽  
Peer Support ◽  
Mental Health System ◽  
The United States ◽  
Telephone Support ◽  
Healthcare Settings ◽  
Professional Perspective

This study stems from an interest in peer support talk, an underexplored area of research, and in how supportive actions such as formulated summaries function in comparison to more professional healthcare settings. Using conversation analysis, this study explores 35 instances of formulations within 65 calls to four different ‘warm lines’, a term for peer-to-peer telephone support within the community mental health system in the United States. Formulations can be characterized across two related axes: client versus professional perspective, and directive versus nondirective. The findings show that formulations within peer support were overwhelmingly nondirective, in terms of meeting institutional agendas to let callers talk. However, formulations ranged from client-oriented ones that highlight or repeat caller reports to those which transform caller reports through integrating past caller experiences or implicit caller emotions. These tactics are found to have similarities to how formulations function in professional healthcare settings.

scholarly journals The United States Eye Injury Registry: Past and Future Directions

Ophthalmology ◽  
2020 ◽  
Author(s):  
Ariel Chen ◽  
Gerald McGwin ◽  
Grant A. Justin ◽  
Fasika A. Woreta
Keyword(s):  
United States ◽  
The United States ◽  
Eye Injury ◽  
Future Directions

scholarly journals Candida auris and Carbapenemase-Producing Organism Prevalence in an Extended Stay Pediatric Hospital, Chicago, Illinois, 2019

2020 ◽  
Vol 41 (S1) ◽  
pp. s145-s146
Author(s):  
Kelly Walblay ◽  
Tristan McPherson ◽  
Elissa Roop ◽  
David Soglin ◽  
Ann Valley ◽  
...  
Keyword(s):  
The United States ◽  
Multidrug Resistant ◽  
Pediatric Hospital ◽  
Mechanical Ventilators ◽  
Candida Auris ◽  
Term Care ◽  
Healthcare Settings ◽  
High Acuity ◽  
Gastrostomy Tubes

Background:Candida auris and carbapenemase-producing organisms (CPO) are multidrug-resistant organisms that can colonize people for prolonged periods and can cause invasive infections and spread in healthcare settings, particularly in high-acuity long-term care facilities. Point-prevalence surveys (PPSs) conducted in long-term acute-care hospitals in the Chicago region identified median prevalence of colonization to be 31% for C. auris and 24% for CPO. Prevalence of C. auris colonization has not been described in pediatric populations in the United States, and limited data exist on CPO colonization in children outside intensive care units. The Chicago Department of Public Health (CDPH) conducted a PPS to assess C. auris and CPO colonization in a pediatric hospital serving high-acuity patients with extended lengths of stay (LOS). Methods: CDPH conducted a PPS in August 2019 in a pediatric hospital with extended LOS to screen for C. auris and CPO colonization. Medical devices (ie, gastrostomy tubes, tracheostomies, mechanical ventilators, and central venous catheters [CVC]) and LOS were documented. Screening specimens consisted of composite bilateral axillae and groin swabs for C. auris and rectal swabs for CPO testing. The Wisconsin State Laboratory of Hygiene tested all specimens. Real-time polymerase chain reaction (PCR) assays were used to detect C. auris DNA and carbapenemase genes: blaKPC, blaNDM, blaVIM, blaOXA-48, and blaIMP (Xpert Carba-R Assay, Cepheid, Sunnyvale, CA). All axillae and groin swabs were processed by PCR and culture to identify C. auris. For CPO, culture was only performed on PCR-positive specimens. Results: Of the 29 patients hospitalized, 26 (90%) had gastrostomy tubes, 24 (83%) had tracheostomies, 20 (69%) required mechanical ventilation, and 3 (10%) had CVCs. Also, 25 (86%) were screened for C. auris and CPO; 4 (14%) lacked parental consent and were not swabbed. Two rectal specimens were unsatisfactory, producing invalid CPO test results. Median LOS was 35 days (range, 1–300 days). No patients were positive for C. auris. From CPO screening, blaOXA-48 was detected in 1 patient sample, yielding a CPO prevalence of 3.4% (1 of 29). No organism was recovered from the blaOXA-48 positive specimen. Conclusions: This is the first documented screening of C. auris colonization in a pediatric hospital with extended LOS. Despite a high prevalence of C. auris and CPOs in adult healthcare settings of similar acuity in the region, C. auris was not identified and CPOs were rare at this pediatric facility. Additional evaluations in pediatric hospitals should be conducted to further understand C. auris and CPO prevalence in this population.Funding: NoneDisclosures: None

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