Using Lean Six Sigma Methods to Develop an Efficient and Sustainable Interdisciplinary Team Program for Chronic Pain...

Area of Science:

• Healthcare Management
• Quality Improvement Methodologies
• Pain Management

Background:

• Chronic pain significantly impacts US military Veterans.
• Pain interdisciplinary teams (IDTs) represent the optimal approach to pain management.
• A standardized framework for developing and implementing IDTs within complex healthcare systems is lacking.

Purpose of the Study:

• To assess the efficacy of the 9-step Lean 6 Sigma (LSS) methodology.
• To transform a VA outpatient clinic focused on interventional pain services into an efficient and sustainable pain IDT program.

Main Methods:

• The PREVAIL Interdisciplinary Team Track (PREVAIL IDT Track) was developed at a VA Medical Center serving rural Veterans.
• The redesign aimed to decrease driving days, reduce initial pain evaluation consults, increase referrals to Whole Health services, and improve policy compliance.
• Iterative design, testing, and refinement involved feedback from administrators, clinicians, and Veterans, with data collected over a 1-year baseline and 14-month sustainment period.

Main Results:

• The PREVAIL IDT Track reduced in-person appointments from 5 to 2 and required consults from 5 to 1.
• Referrals to Whole Health education classes increased, and the VA achieved full compliance with relevant policies and standards.
• The program has served 486 Veterans, with 167 graduates and 212 current participants, demonstrating sustained clinical impact.

Conclusions:

• The PREVAIL IDT Track demonstrates significant improvements in efficiency and sustainability for pain IDT programs within the VA.
• The Lean 6 Sigma (LSS) methodology shows promise as an effective approach for redesigning pain interdisciplinary teams in VA settings.
• This quality improvement project offers a scalable model for enhancing pain care delivery to Veterans.