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1. Developing an emergency department order set to treat acute pain in sickle cell disease

Author

Yves Duroseau, David Beenhouwer, Michael S Broder, Bonnie Brown, Tartania Brown, Sarah N Gibbs, Kaedrea Jackson, Sally Liang, Melanie Malloy, Marie‐Laure Romney, Dana Shani, Jena Simon, and Irina Yermilov

Subjects
acute pain, analgesics, anemia, emergency medicine, emergency service, hospital, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Study Objective Patients with sickle cell disease (SCD) have many emergency department visits because of painful vaso‐occlusive episodes (VOE). Guidelines recommend treatment within 30 minutes of triage, but this is rarely achieved in clinical practice. Our goal was to develop an order set that is being implemented in the ED to facilitate and standardize emergency care for SCD patients in acute pain from VOEs presenting to the emergency department (ED) in New York City (NYC). Methods Using a RAND/University of California, Los Angeles modified Delphi panel, we convened a multidisciplinary panel and reviewed evidence on how to best manage SCD pain in the ED. Panelists collaboratively developed then rated 202 items that could be included in an ED order set. Results A consensus order set, a practical how‐to guide for managing SCD pain in the ED, was developed based on items that received high median ratings. Conclusions The management of acute pain experienced during VOEs is critical to patients with SCD; ED order sets, such as this one, can help standardize pain management, including at triage, evaluation, discharge, and follow‐up care. After implementation in NYC EDs, studies to examine changes in quality care metrics (eg, wait times, readmissions) are planned.

Published
2021
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2. Developing an emergency department order set to treat acute pain in sickle cell disease

Author

Sarah N Gibbs, Kaedrea Jackson, Dana Shani, Irina Yermilov, Bonnie Brown, Michael S. Broder, Sally Liang, Jena Simon, Tartania Brown, David O. Beenhouwer, Melanie Malloy, Yves Duroseau, and Marie-Laure Romney

Subjects
Modified delphi, Quality care, Disease, sickle cell, quality of health care, emergency medicine, medicine, hospital, Acute pain, emergency service, business.industry, RC86-88.9, practice guideline, acute pain, Medical emergencies. Critical care. Intensive care. First aid, Emergency department, Pain management, The Practice of Emergency Medicine, medicine.disease, Triage, anemia, analgesics, opioid, Medical emergency, business, Order set, Concepts
Abstract

Study Objective Patients with sickle cell disease (SCD) have many emergency department visits because of painful vaso‐occlusive episodes (VOE). Guidelines recommend treatment within 30 minutes of triage, but this is rarely achieved in clinical practice. Our goal was to develop an order set that is being implemented in the ED to facilitate and standardize emergency care for SCD patients in acute pain from VOEs presenting to the emergency department (ED) in New York City (NYC). Methods Using a RAND/University of California, Los Angeles modified Delphi panel, we convened a multidisciplinary panel and reviewed evidence on how to best manage SCD pain in the ED. Panelists collaboratively developed then rated 202 items that could be included in an ED order set. Results A consensus order set, a practical how‐to guide for managing SCD pain in the ED, was developed based on items that received high median ratings. Conclusions The management of acute pain experienced during VOEs is critical to patients with SCD; ED order sets, such as this one, can help standardize pain management, including at triage, evaluation, discharge, and follow‐up care. After implementation in NYC EDs, studies to examine changes in quality care metrics (eg, wait times, readmissions) are planned.

Published
2020

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