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Integrated approach in pain management

Summary of the good practice:

The aim of this practice is to solve problems in both the healthcare service (drug prescription is unified, the clinical course of patients is monitored) and social care settings (avoids the movement of patients with functional limitation, consultations with caregivers are provided, wider agenda to treat patients that do not have a specific appointment).

The main goal of the practice is to improve the care of patients with pain, coordinating the conventional personal assistance with various forms of non in-person care, which allows to improve the delays of waiting lists, avoids impediments to the arrival of patients to the Pain Units and duplication of simultaneous treatments.

To this end, it has designed a Functional Plan for pain treatment by transversal and continuous health-care agreements between primary care, specialized care and the Pain unit.

The specific objectives of the practice include an average delay in first consultation lower than 30 days, more time for face—to-face consultations for infiltrations and reduce to zero the referrals documented in paper.

In addition, the Unified Electronic Health Record (EHR) is incorporated, along with the development of non-face-to-face care pathways, with very positive results measured through quantitative and qualitative methods. Thus, the time available for personal assistance has been increased, and training and the collaboration between professionals of different levels of care have been improved.

Finally, it is necessary to emphasize that the EHR is a key facilitator. It allows sharing all patient information between all professional sand with the patient. It also allows instant electronic consultation and prescription, avoiding duplications and errors of treatment. Its use, along with the development of a non-face-to-face care pathways are transferable key aspects. Thanks tour practice the time available for personal assistance has been increased, and education and collaboration with clinicians in health centres and specialized consultations have been improved.

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Challenge addressed by the good practice

  1. Improve the satisfaction of users of the health system in relation to pain care.
  2. Decrease the high delays to address first consultations in chronic pain patients in the Pain Unit.
  3. Enhance training of healthcare professionals of the Primary Care in pain care.
  4. Avoid unnecessary travel of patients to hospitals.
  5. Improve the satisfaction of health professionals dedicated to the care of the pain.

Key innovative elements of the good practice

  1. The Unified Health Record allows real-time sharing of all patient information among all professionals and the patient, as well as consultation and electronic prescription, avoiding duplicities and errors of treatment.
  2. Functional Plan for pain management with ongoing agreements and transversal care between primary care, specialized care and the Pain Unit allows homogenizing the care of these patients. Now the clinical discharge of the patients loses sense, given the ease of communication and coordinated care between different levels of care.
  3. More time for in-person care according to patient needs, by avoiding many unhelpful face-to-face consultations.
  4. Ecological perspective by saving paper costs.
  5. An average delay in first consultations lower than 30 days.

Full Scirocco information on the good practice

SciroccoGP-Basque-2-Transversal-Approach-of-the-Pain-from-a-Pain-Unit.pdf [PDF]

Publications and reports on the good practice

Documented evidence. Evidence is based on systematic qualitative and quantitative studies.

The information is in the following link of the Spanish National Health System: or.pdf

Contact point: Enrique Barez Hernandez;

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