title: Developing a tool to measure pharmacoeconomic outcomes of post-surgical pain management interventions.
abstract: BACKGROUND
  Financial pressures have limited the ability of providers to use medication that may improve clinical outcomes and patient satisfaction. New interventions are often fraught with resistance from individual cost centers. A value realization tool (VRT) is essential for separate cost centers to communicate and comprehend the overall financial and clinical implications of post-surgical pain management medication interventions (PSMI). The goal was to describe development of a VRT.
  
  
  METHODS
  An evaluation of common in-patient PSMI approaches, impacts, and costs was performed. A multidisciplinary task force guided development of the VRT to ensure appropriate representation and relevance to clinical practice. The main outcome was an Excel-based tool that communicates the overall cost/benefit of PSMI for the post-operative patient encounter.
  
  
  RESULTS
  The VRT aggregated input data on costs, clinical impact, and nursing burden of PSMI assessment and monitoring into two high-level outcome reports: Overall Cost Impact and Nurse & Patient Impact. Costs included PSMI specific medication, equipment, professional placement, labor, overall/opioid-related adverse events, re-admissions, and length of stay. Nursing impact included level of practice interference, job satisfaction, and patient care metrics. Patient impact included pain scores, opioid use, PACU time, and satisfaction. Reference data was provided for individual institutions that may not collect all variables included in the VRT.
  
  
  CONCLUSIONS
  The VRT is a valuable way for administrators to assess PSMI cost/benefits and for individual cost centers to see the overall value of individual interventions. The user-friendly, decision-support tool allows the end-user to use built-in referenced or personalized outcome data, increasing relevance to their institutions. This broad picture could facilitate communication across cost centers and evidence-based decisions for appropriate use and impacts of PSMI.
authors.affiliation: a a Colorectal Surgical Associates, LLP LTD , Houston, TX , USA.
authors.forename: Deborah S
authors.initials: DS
authors.lastname: Keller
authors.affiliation: b b Strategic Market Insight , Acton , MA , USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Smalarz
authors.affiliation: c c Colorectal Surgical Associates, LLP LTD, Division of Colon and Rectal Surgery, Houston Methodist Hospital, Houston, TX, USA, and Division of Minimally Invasive Colon and Rectal Surgery, Department of Surgery, The University of Texas Medical School , Houston , TX , USA.
authors.forename: Eric M
authors.initials: EM
authors.lastname: Haas
mesh_terms: D003362:Cost-Benefit Analysis; D017850:Economics, Pharmaceutical; D006801:Humans; D017059:Models, Econometric; D017063:Outcome Assessment, Health Care / Q000379:methods* / Q000592:standards; D059408:Pain Management / Q000191:economics* / Q000379:methods*; D010149:Postoperative Pain / Q000188:drug therapy* / Q000191:economics*; D017060:Patient Satisfaction
keywords: Healthcare costs; Healthcare outcomes; Opioid associated adverse events; Pain management; Patient satisfaction