Multiple Routes to the Stepped Care Model of Pain Management: VISN 12’s Experience Mary B Karfonta, MSN, NP VISN 12 Pain Point of Contact

The Road We Travelled  VISN 12 Pain Strategic Plan

Changing Directions  Right People  Right Time  What they want changed  What they need from you

Chronic Pain Management Needs Assessment  North Chicago Pain SharePoint 90% Treated Chronic Pain Only 10% Uncomfortable Treating Pain Majority Looking for More Support Patient and Provider Education Contact, Richard Furman, MD North Chicago VAMC

Provider Education  Barriers Time, Time, Time Mandatory CME Funding

Provider Education  Successes VISN 12 Pain SharePoint Interdisciplinary Review Boards Include Patient Advocate Curbside Consults, PKI Grand Rounds, Conferences, Quarterly Pictels Mentoring, PRPs at all Facilities

Patient Education  Barriers Travel Resources, Space Time Reluctance to accept “Self-Management”

Patient Education Success

Additional Program Development  Primary Care Opioid Renewal Clinic Primary Care run Pain Clinic RN Case Management  Secondary Level Specialty pain management clinics Complementary and Alternative Therapies

Tertiary Level  Rehabilitative Pain Management Milwaukee Jill Klayman, PhD

Proposed Programming  Programming Targeted at Women Veterans  Expansion of Milwaukee’s RPM VISN referral Domiciliary-Based CARF accreditation Shared across disciplines Bottom Up Top Down Approach

Poster # 63 Mary B Karfonta, MSN, NP VISN 12 Pain Point of Contact (414) x42106 THANK YOU