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EP037 Development of an automated registry in the electronic health record to track patients managed by the perioperative pain service: a research and quality improvement tool
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  1. Alexandra Sideris1, 2, 3,
  2. William Chan1,
  3. Mary Kelly1,
  4. Samuel Schuessler1,
  5. Patrick Fritz4,
  6. POPS Steering committee1,
  7. Spencer Liu1,2 and
  8. Faye Rim1,2
  1. 1Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, USA
  2. 2Department of Anesthesiology, Weill Cornell Medicine, New York, USA
  3. 3HSS Research Institute, Hospital for Special Surgery, New York, USA
  4. 4HSS Enterprise Analytics Team, Hospital for Special Surgery, New York, USA

Abstract

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.

Abstract EP037 Figure 1

Conceptualization of analytical registry embedded in the electronic health record

Abstract EP037 Figure 2

Perioperative pain service registry inclusion criteria

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.

Abstract EP037 Figure 3

Registry patient demographics and case characteristics

  • perioperative pain management
  • acute pain
  • chronic pain
  • complex pain
  • substance use
  • analytics
  • big data

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