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NoPAIN RetreatNoPAIN Retreat

David Liebovitz, MD

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Multi-disciplinary approach Multi-disciplinary approach beneficialbeneficial

»Diabetes, CHF, cancer, geriatrics and palliative care

»Practice change»Unintended benefits versus harms

»Align goals for practice and research

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Multi-dimensional attention to Multi-dimensional attention to pain is problematic in clinical pain is problematic in clinical

carecare

Physical, psychological, social, spiritual

Contextual assessment inadequate

Linear scales are limited

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Many barriers to effective Many barriers to effective assessmentassessment

Policy Clinician knowledge and skill Patients’ attitudes State of research available

on best approach

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Many potential approachesMany potential approaches

Measurement sciences Clinical practice experience Modeling Informatics…

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Information technology may Information technology may improve pain managementimprove pain management

Acquisition Presentation Guidance Feedback

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Many options for patient Many options for patient information acquisitioninformation acquisition

Prompted nursing documentation

Patient prompted recording»Wireless»Large fonts»No fonts?

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Focused presentation Focused presentation facilitates actionfacilitates action

Diagrams: blinking body parts

Automatic escalation Acknowledgement required

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IT can provide a pain IT can provide a pain management corridormanagement corridor

Consensus approach integration

Interruptive: Required steps Guiding: Responses

monitored within parameters

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An iterative process is An iterative process is required.required.

Defined outcomes for APGF New tactics may be required The job is never complete.