Pain Management Run Charts
July 2007
During the month of July, the General Medicine Pain Service (GMPS) grew to 216 active patients (Chart 1). The Care Assistant (CA) assisted with patient care and follow-up by enrolling 5 new patients and completing 22 telephone calls (Charts 4; 8). Attendance was 80% for the 5 initial visits scheduled with the clinical pharmacist practitioner (CPP; Chart 4). Attendance for the adult nurse practitioner (ANP) and the nurse clinician (NC) remained high this month (Chart 5). Of note, the ANP will not see GMPS patients after this month. The number of scheduled visits for the CPP decreased this month to 46 visits, and the attendance rate remained at approximately 87% (Chart 5). Activity for the GMPS was low this month due to the CPP being on vacation for two weeks, and because there was not a full-time CA. Since there was not a full-time CA, the following data was also not collected: the average wait time to the 3rd available enrollment visit with the CA, the average time from enrollment to the initial visit with the CPP, and schedule availability for the CPP and the NC. There was one dismissal (Chart 9). Data regarding the average PDI is not reported this month as June is the last month that we collected PDI data.
Pain Program Numbers
210 Month 160 110 60 10 31 19 19 15 21 17 25 25 15 27
Pts Awaiting Enrollment Active Patients
(1) Total Number of Patients Enrolled in Pain Program and Awaiting Enrollment The number of current patients actively enrolled in the pain program at the end of each month is shown by this chart. Also highlighted is the number of patients awaiting an introductory visit with the Pain Program CA.
Ju ly .2 Au 006 g. 2 Se 00 pt 6 .2 O 006 ct .2 N 006 ov .2 D 006 ec .2 Ja 006 n. 2 Fe 007 b. 2 M 007 ar .2 Ap 007 r.2 M 00 ay 7 . Ju 200 ne 7 .2 Ju 007 ly .2 00 7
# of Patients
Wait Time for Initial CA Visit
40 35 30 25 Days 20 15 10 5 0
Jan -07 Fe b- 0 7 Fe b- 0 7 Ma r-0 7 Ma r-0 7 Ap r-0 7 Ap r-0 7 Ma y-0 7 Ma y-0 7 Jun -07 Jun -07 Jan -07
Series1
Series2
Month
(2) Wait Time for Initial Visits The time to wait for the first and third initial appointment with the GMPS Care Assistant (CA) is shown by this chart and updated on a weekly basis. The CA visit is used to introduce a patient to the policies and procedures of the GMPS as well as to take a full history of the patient, including past medical, social, and family history, as well as assessment of literacy and depression.
Wait Time to Initial CPP Visit
Average # of Days From Intro Visit
16 14 12 10 8 6 4 2 0
Fe b. 20 07 M ar .2 00 7 Ap r.2 00 7 M ay .2 00 7 Ju ne .2 00 7 Ju ly .2 00 7
Month
(3) Wait Time for Initial CPP Visit The average wait time, from the initial enrollment visit with the CA to the initial appointment for pain management with the CPP, is shown by this chart. During this visit the patient is assessed by the CPP and pharmacological management of pain and depression is initiated.
Attendance for Initial CA and CPP Visits
18 16 14 12 # of Visits 10 8 6 4 2 0
Intro Visit Scheduled Intro Visit Attended Initial CPP Visit Scheduled Initial CPP Visit Attended
May. 2007
2006
Sept .200 6
Aug. 2006
Oct.2 006
Nov. 2006
Jan.2 007
Apr.2 007
June .200 7
Dec. 2006
2007
July.
2007
Month
(4) Initial Visit Attendance The number of patients who are scheduled and attend introductory visits is shown by this chart. Patients who attend introductory visits are assessed by the CA and enrolled into the pain program. The number of initial pain clinician visits scheduled and attended is also shown by this chart. After a patient’s initial visit with the pain clinician, they are considered “active” in the program.
Attendance for Pain Clinicians
120 100 80 60 40 20 0
July .200 6 Aug .20 06 Sep t.20 06 Oct .20 06 Nov .200 6 Dec . 20 06 J an .2 0 07 Fe b . 20 07 Ma r.20 07 Apr .20 07 Ma y.20 07 J un e. 2 0 07 July .20 07
CPP Scheduled CPP Attended NP Scheduled NP Attended NC Scheduled NC Attended
# of Visits
Month
(5) Pain Clinician Patient Encounters Total number of scheduled and completed visits for the CPP, ANP, and NC are shown in this chart. Scheduled visits are appointments set for the patient which he/she may or may not attend. Completed visits are visits that are attended by the patient.
July.
Feb.
Mar.
2007
Schedule Availability for Pain Clinicians
70 60 Available Slots in Template 50 40 30 20 10 0
7-Ma y 9-Ap r an an eb eb ay pr ar ar 12-M 26-M 23-A 21-M 12-F 26-F 15-J 29-J 4-Jun 1-Ja 18-J un n
CPP Week 1 CPP Week 4 ANP Week 1 ANP Week 4 NC Week 1 NC Week 4
Month
(6) Schedule Availability Pain Clinicians The number of available slots on the CPP, ANP, and NC’s template is recorded for 1 and 4 weeks out from each weekly data check and is shown in this chart.
Phone Calls Made by the CA
100 90 80 70 60 50 40 30 20 10 0
91 58 66 50 56 64 73 62 58 52 47 22
Number of Calls
54
(8) Care Assistant Phone Calls The number of phone calls made or received each month by the CA is shown in this chart. Phone calls are completed by the care assistant to follow-up on various issues with patients.
Ju ly .2 0 Au 06 g. 20 06 Se pt .2 00 6 O ct .2 00 6 N ov .2 00 6 D ec .2 00 Ja 6 n. 20 Fe 07 b. 20 07 M ar .2 00 7 Ap r.2 00 7 M ay .2 00 Ju ne 7 .2 0 Ju 07 ly .2 00 7
Month
Number of Patients Dismissed from Pain Program
10 9 8 7 6 5 4 3 2 1 0
Ju n06
Number of Patients
6
3 2 0
00 6 6 6 Ju l-0 6 Se p0 Au g0 O ct N ov .2 -0 6
2 1 0
D ec .2
2 1
2 0
2
2 1
(9) Number of Patients Dismissed from Pain Program The graph displays patients who have been dismissed from the pain program each month. Offenses such as inconsistent urine toxicity results, positive urine toxicity screen for cocaine or amphetamines, diversion, and doctor shopping are reasons for dismissal from the program.
July 2007 dismissals were due to: 1. Positive UTS for cocaine
00 6 Ja n. 20 07 Fe b. 20 07 M ar .2 00 7 Ap r.2 00 7 M ay .2 00 7 Ju ne .2 00 7 Ju ly .2 00 7
Month