title: Preclinic group education sessions reduce waiting times and costs at public pain medicine units.
abstract: OBJECTIVE
  To assess the effects of preclinic group education sessions and system redesign on tertiary pain medicine units and patient outcomes.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Two public hospital multidisciplinary pain medicine units.
  
  
  METHODS
  People with persistent pain.
  
  
  METHODS
  A system redesign from a "traditional" model (initial individual medical appointments) to a model that delivers group education sessions prior to individual appointments. Based on Patient Triage Questionnaires patients were scheduled to attend Self-Training Educative Pain Sessions (STEPS), a two day eight hour group education program, followed by optional patient-initiated clinic appointments.
  
  
  METHODS
  Number of patients completing STEPS who subsequently requested individual outpatient clinic appointment(s); wait-times; unit cost per new patient referred; recurrent health care utilization; patient satisfaction; Global Perceived Impression of Change (GPIC); and utilized pain management strategies.
  
  
  RESULTS
  Following STEPS 48% of attendees requested individual outpatient appointments. Wait times reduced from 105.6 to 16.1 weeks at one pain unit and 37.3 to 15.2 weeks at the second. Unit cost per new patient appointed reduced from $1,805 Australian Dollars (AUD) to AUD$541 (for STEPS). At 3 months, patients scored their satisfaction with "the treatment received for their pain" more positively than at baseline (change score=0.88; P=0.0003), GPIC improved (change score=0.46; P<0.0001) and mean number of active strategies utilized increased by 4.12 per patient (P=0.0004).
  
  
  CONCLUSIONS
  The introduction of STEPS was associated with reduced wait-times and costs at public pain medicine units and increased both the use of active pain management strategies and patient satisfaction.
authors.affiliation: Pain Medicine Unit, Fremantle Hospital, Alma Street, Fremantle, Western Australia. stephanie.davies@health.wa.gov.au
authors.forename: Stephanie
authors.initials: S
authors.lastname: Davies
authors.forename: John
authors.initials: J
authors.lastname: Quintner
authors.forename: Richard
authors.initials: R
authors.lastname: Parsons
authors.forename: Luke
authors.initials: L
authors.lastname: Parkitny
authors.forename: Paul
authors.initials: P
authors.lastname: Knight
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Forrester
authors.forename: Mary
authors.initials: M
authors.lastname: Roberts
authors.forename: Carl
authors.initials: C
authors.lastname: Graham
authors.forename: Eric
authors.initials: E
authors.lastname: Visser
authors.forename: Tracy
authors.initials: T
authors.lastname: Antill
authors.forename: Tanya
authors.initials: T
authors.lastname: Packer
authors.forename: Stephan A
authors.initials: SA
authors.lastname: Schug
mesh_terms: D001071:Appointments and Schedules; D001315:Australia; D002908:Chronic Disease; D015331:Cohort Studies; D003627:Data Interpretation, Statistical; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D017146:Models, Organizational; D010045:Outpatients; D010146:Pain / Q000191:economics / Q000523:psychology; D018710:Pain Clinics / Q000191:economics / Q000458:organization & administration*; D059408:Pain Management; D010349:Patient Compliance; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D011446:Prospective Studies; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D016896:Treatment Outcome