2015 CCOE Award Recipients
Cleveland Clinic Children's Pediatric Pain Rehabilitation Program
The Cleveland Clinic Children’s Pediatric Pain Rehabilitation Program offers pain care services for children and adolescents with chronic pain and related functional impairment. Our core service is a 3-week interdisciplinary pain rehabilitation program providing inpatient and day hospital care for a variety of chronic pain conditions. The primary goals of this program are to help children manage their pain effectively and to restore daily activity.During their first two weeks, patients engage in a broad range of therapy, behavioral health, and physiatry services as inpatients. In the third week, patients obtain these services as day hospital patients.
All patients receive classroom services, and a school re-entry meeting is scheduled prior to discharge. In addition to the inpatient/day hospital program, we offer a multidisciplinary pain assessment clinic; individual and group PT, OT, psychological, and physiatry services; coordinated outpatient therapies; and a day treatment program. Our program maintains a patient registry, and annual outcomes reveal improved functioning, pain reduction, and less health care-utilization. Satisfaction data are reviewed regularly and guide quality improvement initiatives. The Pediatric Pain Rehabilitation Program offers training to fellows and residents in a variety of medical subspecialties and students in physical, occupational, and recreation therapies. A 2-year postdoctoral fellowship in pediatric pain psychology is offered.
Our research efforts, which have been externally-funded, have resulted in multiple publications as well as presentations and posters at national and regional meetings. Program staff have participated in Cleveland Clinic pain-related programming, provided training to multispecialty caregivers, given grand rounds and continuing education presentations at local and regional hospitals, and participate actively in professional pain societies. Our program is the only CARF-accredited interdisciplinary pain rehabilitation program dedicated to children and adolescents. We give particular attention to our program’s culture and core values, including acting as a unit, communication, planfulness, problem-solving, learning/growth, and fun.
Cleveland VA Medical Center Pain Medicine Service
The journey of implementing a biopsychosocial and evidence-based model of care was faced with challenges as we transformed the culture and philosophy of care not only within the Pain Management Center, but throughout the medical center.
The program started as a low-opioids reliance model since its inception in 2004. Through the years, the whole medical center, which cares for over 100,000 veterans, embraced that philosophy. Clinical and behavioral services are offered in a multi-disciplinary fashion by physicians, psychologists, and other allied health care professionals who promote physical rehabilitation and self-management as the mission of our center. Interventional procedures, pharmacologic modalities, psychological interventions, and complementary/alternative medicine are used to facilitate rehabilitation and healthy lifestyles.
Our program follows a 3-level stepped-care model. At Level-I: Patients are managed by primary care providers (PCPs) with pain management training. Through advanced video-teleconferencing, our SCAN-ECHO (Specialty Care Access Network-Extension for Community Health Care Outcomes) team leads weekly training sessions (case-discussion and didactics) with PCP champions. Time is protected for these champions to attend these weekly 90 minute sessions for at least a year. At Level-II, patients are referred to our outpatient clinics where they can be seen by specialists in pain medicine, pain psychology, and other allied professionals. Level-III is the Intensive Outpatient Program (IOP) where more complex patients are referred. In the IOP, patients are enrolled in a 12-week, 1-day/week rehabilitation program that features psychological interventions, aquatic therapy, group exercise, occupational therapy, and dietary and vocational rehabilitation.
Innovation in health care delivery has been at the core of our mission. The Tele-medicine clinics see around 2000 patients yearly, allowing them to receive pain care in facilities close to their homes. Since 2011, our Center has received over $8 million in monetary grant support to fund its innovative initiatives such as SCAN ECHO and Tele-Medicine.
-solving, learning/growth, and fun.
Valley Anesthesiology Consultants/Phoenix Children’s Hospital Pain Medicine Program
The Valley Anesthesiology Consultants (VAC)/Phoenix Children’s Hospital (PCH) Pain Medicine Program is the only comprehensive, multidisciplinary acute and chronic pain medicine program for children in the Southwest. VAC physicians started the program in 2003, and over the years a unique relationship developed between VAC and PCH, which has resulted in a program that minimizes and distributes costs and maximizes services provided. By emulating our innovative organizational model, community hospitals with limited resources can offer better multidisciplinary and multimodal care to the many children who lack access to large academic pain programs, contributing to the fulfillment of the APS stated vision of "a world where pain prevention and relief are available to all people." Despite being a private practice based program we have enjoyed success beyond just the clinical realm. We are one of the exclusive participating sites in the Pediatric Pain Research Consortium (PRN-Pain) of ACTTION. We have multiple ongoing research projects, including multicenter studies, regularly present our work at national meetings, have recent publications in peer-reviewed journals, and have created innovative, collaborative programs such as our Opioid Prescribing Program designed to help promote responsible opioid prescribing and reduce prescription drug abuse. We have regular student and physician rotators from PCH, the University of Arizona, Arizona State University, and the Mayo Clinic, and conduct monthly resident lectures. Some of the CCOE reviewer comments include the following: "The practice offers an impressive number of services in a coordinated fashion. This is especially impressive given they are a private practice." "Especially for a private practice, this program clearly invests in multidisciplinary and multimodal care as a priority, including a well-balanced staffing model that supports their organizational model that emphasizes these important principles." "Truly outstanding application; perhaps the strongest I've ever scored."
Brigham and Women's Hospital, Pain Management Center
The Pain Management Center at Brigham and Women’s Hospital is dedicated to improving access for patients who suffer from pain by providing interdisciplinary care with innovative new programs. The Center has initiated new programs in pelvic pain therapy, addiction disorders, oncology-palliative care, and established a state-of-the-art Spine Center. Other noteworthy recent initiatives include an enhanced role for our certified pain management nurses with development of system-wide care coordination of complex patients with pharmacists and primary care practices.
The Center continues to engage in local, national, and international efforts to promote access to quality pain management services. Our staff have taken leadership roles in national pain societies and have participated in policy decision making at the state and national level. Recently, we have fostered an affiliation with Kuwait to study the epidemiology of pain. We have developed new methods of patient assessment using an electronic PainCAS program and a smartphone pain application. This has allowed us to collect customized outcome measures and implement improved systems for communicating with and monitoring our patients.
Staff of the Pain Management Center are committed to improving knowledge of pain medicine in the community. We actively collaborate with other practices in our health system, have been leaders in developing an educational pain medicine review DVD for primary care providers, and have taught courses on pain research, education, and policy. In addition, our Center trains 10 fellows and 30 residents each year and recently received the Fellowship Excellence Award for the best training program in pain medicine in the country. We also continue to be active in research by producing more than 20 manuscripts per year and obtaining substantial grant support. Our Center’s staff has collaborated with other academic programs in several multicenter trials evaluating outcomes of pain treatment and gaining a better understanding of pain mechanisms.
UC Davis, Center for Pain Medicine
The UC Davis Center for Pain Medicine is dedicated to comprehensive and collaborative patient care, excellence in education, innovative research, patient advocacy, and improving public policy. The Center has a long track record of integrating these broad elements for the greatest benefit of our patients, of our training clinicians, and of the greater global community.
The Center provides seamless evidence-based medical, surgical, psychiatric, psychological, social and alternative care directly within the many facets of its comprehensive programs. Its broad-based approach to treating the community’s most difficult cases of acute, cancer-related, and chronic pain in adults and children is due largely to the inter-professional team whose members are intentionally diverse in their training and perspectives. The Center was one of the earliest to incorporate clinicians from all disciplines and professions.
Engaging in education is a pillar of the program, which includes education for all clinicians across all health professions. Clinicians within the Center are renowned educators and investigators who impact the training of the next-generation of pain care providers across all health professions including pain medicine physicians, primary care, and other specialty clinicians, nurses, nurse-practitioners, physician assistants, psychologists, social workers, as well as patients.
Innovative research is ongoing and spans behavioral, emotional, and physical aspects of pain, analgesic therapies, education, and public policy. This includes work on prescription drug abuse prevention, simulated inter-professional pain education, tele-mentoring for creating rural primary care pain management centers of excellence, safety of interventional pain procedures, the impact of art on coping with chronic pain, and mental health assessment as a core outcome measure in pain care. Recognizing that clinicians from all health professions are inadequately educated about pain, the Center has advanced pain core-competencies in hopes of improving pain education and care within all health professions
The CCOE in Pain Management Awards Program is supported by TEVA Pharmaceuticals.