1. 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

2. The Road We Travelled  VISN 12 Pain Strategic Plan

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

4. 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

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

6. 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

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

8. Patient Education Success

9. 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

10. Tertiary Level  Rehabilitative Pain Management Milwaukee Jill Klayman, PhD

11. 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

12. Poster # 63 Mary B Karfonta, MSN, NP VISN 12 Pain Point of Contact (414) 384-2000 x42106 THANK YOU