Improving access to chronic pain care with central referral and triage: The 6-year findings from a single-entry model.

Journal: Canadian journal of pain = Revue canadienne de la douleur

Volume: 8

Issue: 1

Year of Publication: 

Affiliated Institutions:  Toronto Academic Pain Medicine Institute, Women's College Hospital, Toronto, Ontario, Canada. Department of Anesthesiology, University of Toronto, Toronto Western Hospital, Toronto, Ontario, Canada. Department of Anesthesia and Pain Medicine, Toronto General Hospital, Toronto, Ontario, Canada. Department of Anesthesiology, University of Toronto, Sinai Health, Toronto, Ontario, Canada. Musculoskeletal Rehabilitation Program, Toronto Rehabilitation Institute, Toronto, Ontario, Canada. Department of Anesthesia, St. Michael's Hospital, Toronto, Ontario, Canada. Department of Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada.

Abstract summary 

Despite the established efficacy of multidisciplinary chronic pain care, barriers such as inflated referral wait times and uncoordinated care further hinder patient health care access.Here we describe the evolution of a single-entry model (SEM) for coordinating access to chronic pain care across seven hospitals in Toronto and explore the impact on patient care 6 years after implementation.In 2017, an innovative SEM was implemented for chronic pain referrals in Toronto and surrounding areas. Referrals are received centrally, triaged by a clinical team, and assigned an appointment according to the level of urgency and the most appropriate care setting/provider. To evaluate the impact of the SEM, a retrospective analysis was undertaken to determine referral patterns, patient characteristics, and referral wait times over the past 6 years.Implementation of an SEM streamlined the number of steps in the referral process and led to a standardized referral form with common inclusion and exclusion criteria across sites. Over the 6-year period, referrals increased by 93% and the number of unique providers increased by 91%. Chronic pain service wait times were reduced from 299 (±158) days to 176 (±103) days. However, certain pain diagnoses such as chronic pelvic pain and fibromyalgia far exceed the average.The results indicate that the SEM helped reduce wait times for pain conditions and standardized the referral pathway. Continued data capture efforts can help identify gaps in care to enable further health care refinement and improvement.

Authors & Co-authors:  Di Renna Burke Bhatia Clarke Flamer Flannery Furlan Kumbhare Khan Ladha Meng Smith Sussman Bosma

Study Outcome 

Source Link: Visit source

Statistics
Citations :  The Canadian Pain Task Force . Chronic pain in Canada: laying a foundation for action. 2019 [accessed 2023 Feb 27]. https://www.canada.ca/content/dam/hc-sc/documents/corporate/about-health-canada/public-engagement/external-advisory-bodies/canadian-pain-task-force/report-2019/canadian-pain-task-force-June-2019-report-en.pdf.
Authors :  14
Identifiers
Doi : 2297561
SSN : 2474-0527
Study Population
Male,Female
Mesh Terms
Other Terms
Single-site entry;chronic pain;intake;triage
Study Design
Study Approach
Country of Study
Publication Country
United States