Background and Aims The Perioperative Pain Service (POPS) at Hospital for Special Surgery (HSS) is a multidisciplinary team specializing in the management of acute, chronic, and complex pain in orthopedic surgical patients. The aims of this project were to create an automated registry embedded in the electronic health record that captures surgical cases with any POPS encounter and stores patient metrics over time (figure 1).
Methods After IRB approval, logic functions were programmed within the electronic medical record to capture surgical cases that had an encounter with POPS before, during or after surgery (figure 2). Case characteristics saved daily within the database include patient demographics, pain intensity, and surgery details, with more metrics being programmed and validated.
Results Between January 2022 through April 2023, 6,475 scheduled surgical cases met registry criteria (figure 2). Out of these cases, 1,183 (18%) had a preoperative pain consultation, 4,561 (70%) involved the acute pain service, 1,580 (24%) involved the chronic pain service, and 31 (0.46%) required a post-discharge pain consultation. Patient-controlled analgesia was utilized in 5,668 (88%) cases of which 3,810 (60%) received only intravenous opioid and <1% received a perineural catheter.
Conclusions As the first encounter-based, analytical registry at HSS, the POPS registry represents a proof-of-concept, auto-updating data repository designed for an inpatient pain management specialty service. Research and quality improvement projects leveraging this registry may elucidate improvements in the preoperative pain screening referral workflow and identify modifiable risk factors and multimodal strategies to mitigate severe acute pain, opioid consumption, and resource utilization in complex pain patients.
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