Evidence map›Paper›PMID 39483953›Full record

ArticleGlobal advances in integrative medicine and health

Using Lean Six Sigma Methods to Develop an Efficient and Sustainable Interdisciplinary Team Program for Chronic Pain in a VA: PREVAIL Interdisciplinary Team Track.

Rena E Courtney, Mary J Schadegg, Natalie Hicks, Melissa Truitt, Rendelle E Bolton, Brian Dezzutti, Francis Cannizzo, Beth D Darnall, Marilyn Radatz, Samantha M Harden

Abstract read
In one paragraph

Article in Global advances in integrative medicine and health. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Rena E CourtneyPREVAIL Center for Chronic Pain, Salem VA Health Care System, Salem, VA, USA.ORCID https://orcid.org/0009-0009-0195-7393
Mary J SchadeggNew York University Grossman School of Medicine/New York University Langone Health, New York, NY, USA.
Natalie HicksPREVAIL Center for Chronic Pain, Salem VA Health Care System, Salem, VA, USA.
Melissa TruittPREVAIL Center for Chronic Pain, Salem VA Health Care System, Salem, VA, USA.
Rendelle E BoltonCenter for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA, USA.
Brian DezzuttiPREVAIL Center for Chronic Pain, Salem VA Health Care System, Salem, VA, USA.
Francis CannizzoSalem VA Health Care System, Salem, VA, USA.
Beth D DarnallDepartment of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA.
Marilyn RadatzSalem VA Health Care System, Salem, VA, USA.
Samantha M HardenDepartment of Psychiatry and Behavioral Medicine, Virginia Tech Carilion School of Medicine, Blacksburg, VA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Chronic pain is highly prevalent in US military Veterans, and pain interdisciplinary teams (IDTs) are the gold standard in pain care. There is no standard or guidance for how best to develop and implement pain interdisciplinary teams within complex health care systems. Objectives: The purpose of this quality improvement project was to evaluate the effectiveness of the standard 9-step Lean 6 Sigma (LSS) methodology in redesigning a pre-existing VA outpatient pain clinic solely offering interventional pain services into an efficient, sustainable pain IDT program. Methods: The initial evaluation process at a VA Medical Center that primarily serves rural Veterans was redesigned with the a priori goal of developing an efficient, sustainable IDT program that decreased driving days (ie, in-person appointments) required for a comprehensive initial pain evaluation, decreased number of consults required for initial pain evaluations, increased the number of consults to Whole Health services, and increased compliance with policies and standards. Feedback from administrators, clinicians, and Veterans was used to identify inefficiencies then iteratively design, test, and finalize a redesigned service called the PREVAIL Interdisciplinary Team Track (PREVAIL IDT Track). Baseline data was collected for 1 year followed by sustainment data for 14 months. Results were analyzed using descriptive statistics. Results: PREVAIL IDT Track decreased the number of in-person appointments from 5 to 2, decreased consults required for evaluations from 5 to 1, increased the number of unique consults to Whole Health education classes, and made the VA fully compliant with policies and standards. To date, 486 Veterans have participated in the redesigned program, including 167 graduates and 212 current enrollees in this sustained clinical program. Conclusion: The success of PREVAIL IDT Track suggests that LSS may be a promising method for redesigning sustainable pain IDTs in VA that improve efficiency.

Indexed as

delivery of health carepatient care teamsystems integrationveterans

Identifiers

PMID39483953
PMCPMC11526189

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.