Inpatient Multimodal Path to RecOVEry

Study Overview
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Brief Summary
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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
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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.

Official Title
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Inpatient Multimodal Path to RecOVEry

Conditions
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Pain, Opioid Use

Intervention / Treatment
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* Other: IMPROVE Protocol


Participation Criteria
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Eligibility Criteria
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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.
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: IMPROVE Protocol<br>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. | Other: IMPROVE Protocol<br>* Comprehensive pain management protocol<br>|
| No Intervention: Usual Care<br>Treatment of patients in the usual manner based on their diagnosis and resources available at that site. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Use of Opioid Overdose Reversal Treatment | Incidence of administration of opioid reversal agent | Patient's entire length of stay in the hospital, up to 3 months | 

Secondary Outcome Measures

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

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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opioid, inpatient, pain, multimodal