Delphi study to explore indicators of high functioning pain management teams

Chronic pain is optimally managed through a comprehensive, interdisciplinary, and multimodal approach. However, strategies for implementing pain management teams (PMTs), including their structure, services, and interaction with the broader healthcare system vary significantly across medical centers. Within the Veterans Health Administration, the largest healthcare organization in the US, medical centers increasingly utilize PMTs of varying forms and sizes. The current study aimed to identify indicators of and work toward a consensus definition of a high-functioning PMT. This study used a modified Delphi study using a panel of 47 pain management experts. Panelists completed a three round process resulting in consensus indicators of high-functioning PMTs. Subsequent qualitative analyses were used to identify conceptual domains and organize responses. Findings identified 49 unique consensus indicators that were organized under four conceptual domains: Team Characteristics and Values, Team Background and Services, Clinician-Patient Interactions, and Health System Integration. Exemplar indicators include respect for team members, provision of medication management, patient communication, and facility support for team. The large number of indicators of high functioning pain management teams identified in this study speaks to the complexity of providing comprehensive pain care. Several findings build upon previous indicators identified in other interdisciplinary team literature, particularly those falling under the domain of PMT Characteristics and Values, while the remaining domains allude to unique considerations for pain specialists. These findings provide a framework for future studies to identify and build mechanisms through which to measure and facilitate implementation of PMTs across medical centers. PERSPECTIVE: A Delphi study was conducted to identify indicators of high-functioning pain management teams. Consensus indicators were organized into four conceptual domains, Team Characteristics and Values, Team Background and Services, Clinician-Patient Interactions, and Health System Integration, with implications discussed.