Inpatient Multimodal Path to RecOVEry

Not Applicable

Withdrawn

Brief Summary: The goal of the proposed study is to develop and implement a comprehensive strategy to address pain management in the inpatient setting while appropriately managing pain and optimizing patient safety in the inpatient setting. This strategy involves developing a new health Information Technology tool in the Omnicell and electronic medical record, implementing a "menu" of pain management and relaxation strategies, and developing educational materials for staff and patients to change the culture of pain management.

Detailed Description: The goal of the proposed study is to develop and implement a comprehensive strategy to address pain management in the inpatient setting while appropriately managing pain and optimizing patient safety in the inpatient setting. This strategy involves developing a new health Information Technology tool in the Omnicell and electronic medical record, implementing a "menu" of pain management and relaxation strategies, and developing educational materials for staff and patients to change the culture of pain management.

This intervention will be implemented throughout CHS hospitals, using a stepped wedge design to guide rollout. The initial pilot will be conducted in the trauma inpatient units at Carolinas Medical Center. All patients admitted to the two primary trauma units (11A and 11 Tower) during the pilot study period will be included in the evaluation.

Recruitment & Eligibility

Inclusion Criteria

All patients treated in facility as inpatient during the study period will be included in the analysis.

Exclusion Criteria

Patients not admitted to facility during the study period will be excluded from the analysis.

Arm && Interventions

Group	Intervention	Description
IMPROVE Protocol	IMPROVE Protocol	The intervention is composed of 4 parts: 1) a multidisciplinary team that recommends, develops, approves, monitors the components of the intervention and training? 2) monitoring of medication sedation risk using established scale 3) restriction of medication dispensing via enhanced technology 4) health professional training on multimodality pain management including complementary and alternative therapies.

Primary Outcome Measures

Name	Time	Method
Use of Opioid Overdose Reversal Treatment	Patient's entire length of stay in the hospital, up to 3 months	Incidence of administration of opioid reversal agent

Secondary Outcome Measures

Name	Time	Method
Multimodal Therapy	Patient's entire length of stay in the hospital, up to 3 months	Percentage of patients receiving multimodal pain management
Pain	Patient's entire length of stay in the hospital, up to 3 months	Average daily pain scores (VAS)
Oversedation without naloxone	Patient's entire length of stay in the hospital, up to 3 months	Incidence of patient oversedation (Pasero \> 2 or associated diagnosis code)
Average Daily MME	Patient's entire length of stay in the hospital, up to 3 months	Morphine Milligram Equivalent Dosing for Opioid Medications

Locations (12): Carolinas Healthcare System - Stanly
🇺🇸
Albemarle, North Carolina, United States
Carolinas Medical Center
🇺🇸
Charlotte, North Carolina, United States
Carolinas Healthcare System - Pineville
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Charlotte, North Carolina, United States
Carolinas Healthcare System - Kings Mountain
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Kings Mountain, North Carolina, United States
Carolinas Healthcare System - Cleveland
🇺🇸
Shelby, North Carolina, United States
Carolinas Healthcare System - Mercy
🇺🇸
Charlotte, North Carolina, United States
Carolinas Healthcare System - University
🇺🇸
Charlotte, North Carolina, United States
Carolinas Healthcare System - Lincoln
🇺🇸
Lincolnton, North Carolina, United States
Carolinas Healthcare System - Union
🇺🇸
Monroe, North Carolina, United States
Carolinas Healthcare System - NorthEast
🇺🇸
Concord, North Carolina, United States
Carolinas Healthcare System - Blue Ridge
🇺🇸
Morganton, North Carolina, United States
Carolinas Healthcare System - Anson
🇺🇸
Wadesboro, North Carolina, United States