Background and Significance Development of a Specialized Pain Management Program in a Rural Community Bryan Hunter, DNP, CRNA, NSPM-C ● Matthew Stokes, DNP, CRNA, NSPM-C ● John Maye, PhD, CRNA, CAPT (ret) USN University of South Florida, College of Nursing Introduction Background and Significance Methodology Results In order to improve access to care in rural communities for specialized pain management services the CRNA has emerged through leadership and preparation to fill this critical need. Post-Graduate Advanced Pain Management Fellowships now exist that assist the CRNA in securing the didactic and clinical expertise required. Rural CRNAs are uniquely positioned to address chronic pain in rural populations Pain Fellowships are available for CRNAs Board certification in Pain Management is available to CRNAs Formal guidance or recommendations for the development of CRNA led pain programs are nonexistent Development of these programs are complex and fraught with challenges. To date, the literature is void of information providing guidance to those who are interested in pursuing this challenge. This initiative is the first formal attempt at providing structure and guidance to those rural CRNAs who desire to provide these services. Implementation Plan Guidebook Dissemination Initial limited Printing Courtesy Copies presented to established CRNA pain providers for evaluation and input Revised Guidebook final printing Publication and ISBN assignment Guidebook Promotion Professional organizations (AANA) Academic Institutions Social Media Made available for purchase through online retailers Simulation-Based Academic Fellowship in Advanced Pain Management Advanced certifications are an essential component to establish credibility and document expertise in the field. In 2015, The National Board for the Certification and Recertification of Nurse Anesthetists administered the first exam for a newly developed voluntary board certification in advanced pain management. Providers with this credential are designated by “NSPM-C”, which stands for “Nonsurgical Pain Management Certified”. Discussion Results An increased number of CRNAs are venturing into the field of specialized pain management. Board certified, pain management CRNAs lack a clear and concise methodological approaches for initiating and maintaining successful pain management programs in a rural environment. The final product produced by this project integrates all relevant information into a clear and concise guidebook to assist the chronic pain CRNA with initial practice development and also ongoing practice evaluation. Guidebook Table of Contents Rural, board-certified CRNAs are uniquely positioned to provide specialized pain management services in areas that have traditionally lacked specialized healthcare providers. Fellowships in pain management, along with rigorous board certification, ensure competent, high-quality care. Board certified, pain management CRNAs continue to lack a clear and concise methodological approach for initiating and maintaining a successful pain management program in a rural environment. Preface Introduction Section 1 - Getting Started Chapter 1 - Overview of a rural pain practice Chapter 2 - Education, Training & Credentialing Chapter 3 - Institutional & Community Support Section 2 - Infrastructure Chapter 4 - Collaborative Care: The Integrative Pain Management Team Chapter 5 - Personnel Chapter 6 - Informatics Chapter 7 - Equipment Section 3 - Special Considerations Chapter 8 - Financial: Insurance & Billing Chapter 9 - Market Analysis Chapter 10 - Measurable Outcomes as Quality Indicators Appendix A - Equipment List Appendix B - Sample Dictation Notes Appendix C - Sample Patient Forms Appendix D - Revised Oswestry Disability Index References   Methodology Critical appraisal of existing literature A Review of Existing Information Obtained from the Development of a New Pain Management Practice in a Rural Community. Institutional Support Community Support and Advertising Analysis of community demographics Education, Credentialing and Training Financial/Insurance Issues Market Competition Market Share Analysis Determination of Measurable outcomes Development of Implementation plan that will assist rural CRNAs with understanding and implementing the critical components necessary for development of a specialized pain management program Acknowledgements We would like to thank Dr. John Maye for his unending support and mentorship. Dr. Maye has been a pioneer for CRNA led pain management. Purpose . The primary objective of this program development initiative was to develop a guidebook which provides the fellowship trained nurse anesthetist with a methodological approach for initiating and maintaining a successful specialized pain management program in a rural environment. References References available upon request.