SHM Converge Scientific Abstract ePoster Gallery-Design and Dissemination of an Acute Pain Management Guideline and Order Set for the Medically Admitted Patients

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Northwell Health Hospital Medicine identified inconsistent use of guideline-based multimodal analgesia for acute pain in medically admitted patients, including those receiving opioids. The team saw an opportunity to reduce variation in care, limit opioid-related side effects and misuse, and improve pain control. This need was especially important because the organization operates across four EMRs in 16 hospitals, and previously lacked comprehensive inpatient acute pain guidance or supporting order sets.<br /><br />To address this, Northwell developed an enterprise-wide acute pain management guideline and corresponding order set. The guideline was created over several months by hospital medicine physicians and a project manager, with input from pain specialists, nursing, and pharmacy. It was posted on the intranet and SharePoint. The order set, built in the main EMR at 12 of 16 hospitals, made it easier to order recommended non-pharmacologic and non-opioid therapies, evidence-based opioid regimens when needed, and automatic bowel regimens and naloxone when opioids were selected. It also linked directly to the guideline and local prescription monitoring program.<br /><br />To promote adoption, the team conducted 17 short educational sessions between May and August 2022, usually embedded in existing team meetings or GME conferences, along with email and routine departmental updates. After implementation and education, order set use increased from 1,385 instances in 2022 to 3,392 in 2023.<br /><br />The project concluded that thoughtful guideline and order set design alone is not enough to ensure uptake. Short, live education delivered where clinicians already gather was important for initial adoption. Ongoing sustainment will likely require continued visibility of the guideline and order set, plus future dashboards to monitor adherence and support quality improvement.

Asset Subtitle

Joshua Case

Meta Tag

Author List Joshua Case, Katherine Lerner, Samantha Fricke, Sanjeev Sharma

Category Innovations

Concept Acute Pain Management Guideline

Concept Multimodal Analgesia

Concept Acute Pain Order Set

Concept Inpatient Prescribing Variation

Concept Opioid-Related Risk

Distinguished Non-Finalist

Presenter Organization Northwell Health

Presenting Author Joshua Case

Track Translating Research into Practice

Keywords

acute pain management

multimodal analgesia

opioid stewardship

inpatient guideline

order set

hospital medicine

non-opioid therapies

naloxone

educational sessions

quality improvement

Acute Pain Management Guideline

Multimodal Analgesia

Acute Pain Order Set

Inpatient Prescribing Variation

Opioid-Related Risk

Joshua Case, Katherine Lerner, Samantha Fricke, Sanjeev Sharma

Innovations

Non-Finalist

Northwell Health

Joshua Case

Translating Research into Practice