New Pain Service to Assist with Chronic Pain Management

Trinity Muscatine is expanding its pain management services to address the need of patients suffering from chronic pain in the community. According to the National Institute of Health, (NIH) pain affects more Americans than diabetes, heart disease and cancer combined. Pain is a complicated, and in some situations, debilitating medical issue that is often not addressed adequately.

Pain is the most common symptom for which patients seek care, and according to a 2003 study conducted by Peter D. Hart Research Associates, over 117 million adults experience chronic pain. Frequently, chronic pain has a negative impact on the physical and mental well-being of those that suffer. Statistics gathered by the NIH (National Institute of Health) revealed that chronic pain is the most common cause for long-term disability.

"Frequently, we see patients come into the Emergency Room suffering from chronic pain. Unfortunately, services in any ER (emergency room) are not a long-term solution for managing chronic pain, " says Penny Crowe, Trinity Muscatine Outpatient Care Director.

A 2006 survey conducted by the National Center for Health Statistics revealed 26% of adults experienced pain lasting for more than 24 hours in the month prior, and 10% had experienced the same pain for more than a year.

"The goal of pain management is to minimize pain, rather than eliminate it. This is because quite often it is not possible to completely do away with it (pain)." says Vice President of Medical Affairs, Dr. Matthew Sojka.

In addition to improving patients’ quality of life and expanding services in the Muscatine area, the purpose of the Pain Management Clinic is to help patients return to their everyday activities quickly and without heavy reliance on medications.

Primary care physicians must refer patients wishing to be treated by Pain Management Clinic. An initial consultation will determine if a patient is accepted for treatment. The Pain Management Clinic will communicate treatment plans to the referring physician as needed. The service will see patients on the 1^st and 3^rd Mondays of each month, beginning on June 21^st in the Trinity Muscatine SurgiCenter area.

Trinity operates four full-service hospitals in Rock Island and Moline, Illinois, and Bettendorf and Muscatine, Iowa, with a total of 595 licensed inpatient beds and 11 hospice beds, as well as 27 primary care and specialty clinics with 100 employed physicians. Trinity also operates Trinity Visiting Nurse and Homecare Association, Trinity Home Care Products, the Robert Young Center for Community Mental Health, Trinity Muscatine Public Health, Trinity College of Nursing and Health Sciences and Trinity Osteopathic Family Practice Medical Residency Program.

New Electronic Medical Record (EMR) System to Improve Patient Safety and Communication

MUSCATINE- Trinity Muscatine has implemented another piece of a $4.7 million, multi-year roll out of the electronic medical record (EMR) initiative to enhance healthcare delivery throughout its service area.

Trinity Muscatine’s goal of becoming completely electronic by 2011 edged a little closer with the implementation of the EMR in the Emergency Department.

"The most important element of the EMR is the impact on patient safety. The electronic medical record places all patient information at the provider’s fingertips at the point of service." says Dr. Matt Sojka, Vice President of Medical Affairs. "Regardless of how patients access services – emergency department, laboratory, x-ray, clinics or urgent care- healthcare providers will be able to retrieve the latest updates with the EMR."

Improved patient flow in the Emergency Department is also made easier by a large screen monitor connected to the EMR. This monitor displays the dates of birth and medical problem when patients are checked into the Emergency Department. This enables physicians and emergency department staff to prioritize each patient’s needs at a glance while protecting confidentiality. Wait time is also displayed, a feature that assists with decreasing patient’s time spent in the Emergency Department. Additionally, the screen allows medical staff to quickly see the location of the patient. The progress of patients in radiology, for example, can be monitored on the big screen.

The American College of Emergency Physicians (ACEP) states the EMR in emergency departments will advance improved patient care and safety. An effective medical record initiated in the ED will support:

• Incorporation of testing results including radiology and laboratory
• Comprehensive communication with other providers
• Follow up care coordination
• Discharge instruction communication

Successful integration of the EMR enables Emergency Department staff to accurately capture the evaluation of patients and the medical decisions, in addition to the record being made available almost immediately. Interpretation errors decrease, as providers are able to enter patient information directly into the EMR, thereby increasing patient safety.

"The EMR in the Emergency Department will allow the E.D. physicians to complete the patient’s record as soon as they are discharged. This will in turn give primary care physicians immediate access to the patient’s visit and improve follow up care." says Dr. Eric Schmieg, Emergency Department Director.

Trinity operates four full-service hospitals in Rock Island and Moline, Illinois, and Bettendorf and Muscatine, Iowa, with a total of 595 licensed inpatient beds and 11 hospice beds, as well as 27 primary care and specialty clinics with 100 employed physicians. Trinity also operates Trinity Visiting Nurse and Homecare Association, Trinity Home Care Products, the Robert Young Center for Community Mental Health, Trinity Muscatine Public Health, Trinity College of Nursing and Health Sciences and Trinity Osteopathic Family Practice Medical Residency Program.

MUSCATINE - Trinity Muscatine recently implemented the Bedside Medication Verification (BMV) process which provides additional patient safety precautions in medication administration.

The Bedside Medication Verification process is the latest addition to Trinity Muscatine’s strategy for an entirely electronic medical record. With many of the components already in place, Trinity’s plan is to be completely electronic by early 2011. The EMR (electronic medical record) will allow medical staff to view patients’ health history to assure continuity of care.

Using bar code technology commonly seen at the supermarket, the BMV process increases the efficiency and accuracy of delivering quality healthcare. Caregivers scan a bar code on the patient’s wristband and on the medication. Prior to administering medication, the BMV provides instant confirmation of the "Five Rights" of medication management; right patient, right medication, right route, right time and right amount. With this new technology, an additional set of checks and balances are in place to ensure patient safety.

"This is a major step forward in patient safety in medication administration for the hospital," says Dr. Robert Weis. "It (BMV) is part of the progression of advances of the EMR (Electronic Medical Records) at Trinity Muscatine. It is consistent with the Institute of Medicine and federal government's emphasis of health information technology."

Across the nation, each year thousands of people are harmed by preventable medication errors. Time in the hospital is extended, and in some instances, the adverse effect of the medication leads to death. Such errors include overlooked drug allergies and interactions, illegible handwritten instructions and the miscalculation of the decimal point resulting in an over/under dose.

Substantial financial loss is consequence of medication errors as well. Just one adverse drug event (ADV) can add thousands to the cost of hospitalization. Nationwide, ADV’s translate into billions of dollars of unnecessary costs. In addition to patient safety, healthcare organizations must consider the costs of malpractice insurance and loss of productivity.

The BMV helps the communication between the pharmacy, physicians and nursing. Physicians can access the BMV system at anytime to assess and monitor a patient. If a patient’s medication needs to be adjusted, the new orders can be reflected immediately for the appropriate administration of the drug. "The BMV is an extremely helpful tool in providing superior care", says Brenda Robles, RN at Trinity Muscatine. "It decreases human error which improves patient safety."

Deb Caldwell, an OB RN says the accountability the BMV provides for the "5 Rights" is immeasurable. "This is a positive change, and another example of Trinity Muscatine’s commitment to the patient and community."