May 16, 2011
by Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP candidate, PREP-AIRED moderator and administrator, Tufts University School of Medicine
When Bat Masterson, RN, a former Navy nurse, was hired as the emergency department case manager at Kootenai Medical Center, a 246 bed acute care hospital in Coeur d’Alene, Idaho, he recognized that an effective, collaborative, multidisciplinary pain management plan was needed. He saw that repetitive emergency department visits for pain issues were often the norm for patients without primary care health care providers and there was limited follow-up for effective pain management for these patients. Additionally, staff were often burdened by responding to drug-seeking or doctor-shopping individuals who visited the emergency department repeatedly to attempt to obtain narcotic prescriptions. In 2006, Mr. Masterson and a multidisciplinary team of health care professionals developed the Pain Care Management Program that embraced a coordinated care model and electronic communication tools to monitor and support pain patients who visited the emergency department. Four goals of emergency department pain care were identified by the team and served as guiding principles in the development of strategies and interventions of the Pain Care Management Program of Kootenai Medical Center.
- Manage patients with chronic pain or pain related complaints through coordination of care with the patient’s primary physician and the Emergency Department.
- Support the treatment goals of the primary physician without encumbering the Emergency Department.
- Use non-narcotic pain relief, whenever possible, and as a standard of care for the treatment of headaches.
- Provide the best care for the patient for the condition they have that day
The results of the Pain Care Management Program have been impressive:
- A 77% reduction in emergency department visits for pain care management.
- An increase from 42% to 89% of individuals in the pain care study with primary care providers
- Improved patient and nursing satisfaction scores
Congratulations to Bat Masterson, RN and the emergency department pain care management team at Kootenai Medical Center for an innovative and collaborative model of pain care.