The Pain Medicine, Palliative Care, and Integrative Medicine Program (PMPCIM) at Children’s Hospitals and Clinics of Minnesota (Children’s) serves more than 900 pediatric patients annually (two-thirds on an inpatient basis). About 700 of these children receive treatment for acute pain issues, and another 200 seek treatment for their chronic noncancer pain.
Pain management education, resources, and follow-up counseling are available to families and are accessible to any child in Children’s institutional network. The PMPCIM’s psychologists, physical therapists, and integrative medicine specialists provide services ranging from patient and family counseling to biofeedback, acupuncture, physical therapy, and pharmacological/medical management. Initiatives address combining new technology and pharmacology with complementary medicine and provision of culturally sensitive care (cultural liaisons engage patients and families throughout the process).
Children’s also maintains the Children's Institute for Pain and Palliative care, which has provided training, education, and resources to more than 1,000 people during the last several years. Children’s is also a Center to Advance Palliative Care Leadership Center, offering training courses to developing U.S. palliative care programs and regional rural outreach training.
Dr. Stefan Friedrichsdorf, MD, medical director, has developed the No Needless Pain Initiative, a hospital-wide quality improvement (QI) program that will positively impact thousands of patients and families. As part of this initiative, Children’s collaborated with hospital leaders to develop rapid QI pain projects and added a protocol through which any child in pain (or parent) may request a pain team consult on a 24/7 basis. Three in-house research staff members are employed, and 12 investigatorinitiated
active studies are in place.
One CCOE award reviewer commented, "This program is patient-centered, with many strengths in complementary approaches and palliative care, and very good work with families." Another reviewer praised, "Their education initiatives lead the world!"
The Neuromedicine Pain Management Center offers a uniquely integrated approach to the treatment of over 2,000 patients each year. The Center combines medical, behavioral, procedural, and rehabilitation modalities at a single regional outpatient hub. Because chronic pain arises in the nervous system, evaluation begins with specialists in neuromedicine. With specialists from neurology, neurosurgery and allied fields working together, a range of diagnostic perspectives are considered and treatment courses outlined at the outset. For example, in the course of a visit, a patient with possible trigeminal neuralgia is examined by a neurologist; a neuroradiologist who interprets imaging findings; and a neurosurgeon who explores the gamut and timing of procedural treatment options. Case conferences and routine measurement along 16 dimensions of patient experience are mainstays of the effort to improve outcomes.
The Center is committed to educating practicing providers and trainees at all levels. The Advances in Pain Management Continuing Medical Education (CME) Series annually draws more than 160 participants. Its monthly Translational Pain Research Forum CME series, launched in 2009, brings together basic and clinical scientists with pain practitioners of all types throughout the region. One CCOE award reviewer noted, "This program has a very robust commitment to education of pain scientists and clinicians."
The Center’s clinical research focuses on neuropathic pain conditions, low back pain syndromes, and novel therapies. Another reviewer summarized, "This program seems to nail it in translational research! This is something rare, even among top university pain programs."
Access to comprehensive care is a major barrier to improved treatment for the population of patients with chronic pain. The Center addresses this problem by ensuring provider continuity; staffing a bilingual team; and with its recent launch of a regional outreach clinic located 70 miles away, providing services in an underserved rural area with limited access to integrated care.
The CCOE in Pain Management Awards Program is supported by TEVA Pharmaceuticals.