Università “Sapienza” Az. Policlinico Umberto I°

Superior School of Pain Medicine

Project for a coordinated care of posthraumatic pain

Israel- Rome- Palestine

Prof. Rosanna Cerbo

Responsible for Pain Medicine Centre

Abstract :

The primary aim of our project is to offer, through network between Universities of different Coutries involved, the hightest level of experience in thraumatic pain medicine and the most effective care interventios known for acute e chronic pain ( various kinds of wound,
fractures, burns, etc) and rehabilitation of patient with physical, psychological and social disability through integrated care with multidisciplinary approach. Attention should be focused on phantom limb syndrome and on complex regional pain syndrome. The effect of thraumatic pain on social and phyisical disability and occupation will also be evaluated.

a) Education of healthcare personnel and of different healthcare professionals involved in interested Countries and education of patients and their families through specific educational and support programs, in order to guarantee psychological and social support.

b) Healthcare interventions according to common protocols defined by different University Centres involved in our project : global care of patient, sistematic evaluation of pain, carrying out of drug therapy and rehabilitation protocols and definition for each patient of individual goals, checked on by territory physicians.

c) Creation of a computerized and human regional horizontal and vertical network , that should allow continuous comunication between different healthcare structures involved: Pain Therapy Centre “ E. Borzomati” at " La Sapienza" University of Rome , An-Najah National University of Palestine and Al-Quds University of Jerusalem.

d) Foundation of a specific regional observatory of thraumatic pain in heathcare structures , in particular in hospitals

e) Health economy studies for evaluation of economic burden of thraumatic pain and thraumatic disease on collectivity in different Countries, throught definition of problems about disease management and wasting of public resources (Cost of illness analysis). Such analysis allows better distribution of available resources, evaluation of cost-benefit ratio of providing a specific service, acquisition of data about available financial resources and expense for care of patients with acute and chronic post thraumatic pain. Such data are needed to develop a policy based on rationalization of wasting of global public resources.

f) Development of competitive and innovative search and education programs of national and international relevance.

Healthcare goals of our project for a coordineted care of posthraumatic pain

Israel Rome Palestine

1)Definition, diffusion and application of clinical and organizational guidelines and of diagnosis and care protocols for thraumatic pain, wih determination of a diagnostic/therapeutic course agreed with territory healthcare structures

A) Thraumatic pain care in emergency situations with on-the-spot first aid interventions according to definite protocols, balancing clinical and logistic needs

Receive, register and selection calls

Determine criticality of event

Encode calls and answers

Operation Room (one for each University Centre taking part to our Project) endowed with a phone system, a radio contact system, a computer system

B) Ensure coordination of costomers’ requests with availability of healthcare

C) Healthcare at hospital, consulting room or home. The first individual treatment plan after event will be defined on the basis of global Centre evaluation according to specific protocols. Patient will be treated at territory hospitals either as inpatient or as outpatient with a well-framed care program, following an integrated course whose results will be checked on through check-up at home or at consulting room agreed with territory healthcare structures. It is iportant to

- Guarantee psychological support for patients and their families

- Organize healthcare structures for patients needing protheses

- Hospice Care for patients whose autonomy is nearly totally or totally lost or who can no longer be treated at home, in particular for patients who need rehabilitation or patients with motor handicap, either of neurologic or orthopedic origin, who complaint chronic pain because of their specific disease. Healthcare at hospice will be carried out through multidisciplinary equipe work and coordinated with other project features.

D) Promote a working group for prevention and treatment of bedsores composed by physicians and nurses with the following tasks :

1. diagnosis and therapy for Centre inpatients

2. homecare for discharged patients (continuità terapeutica);

3. training courses for Centre and external healthcare personnel

2 Creation of a computerized comunication network between hospitals involved, family practicioners and territory healthcare structures.

3 Second medical opinion : clinical opinion supported by acquired data sent to a remote physician who will analyze them producing a second clinical evaluation of a patient

Training and educational activity for an integrated care of posthraumatic pain

Israel Rome Palestine

Training activity will be performed in collaboration with “Sapienza” University of Rome and the Faculties of Medicine of An-Najah National University of Palestine and Al-Quds University of Jerusalem and will be addressed to physicians, practicioners, nurses and volunteers operating on the territory involved by our project permanent update and education on program guidances about ethic, psychological and clinical features of chronic pain.

Distance learning ( e-learning and telemedicine) through training courses and competitions, for healthcare personnel dealing with pain and palliative care is foreseen . Our Centre applies an interdisciplinary approach to pain study , with global evaluation of patient, sistematic assessment of pain, definition of outcomes and treatament protocols , auxiliary care, counseling and patient and family education. Particular attention will be focused on training of healthcare professionals able to manage pain in urgency and maxi- emergency situations.

Our Centre co-operates with conventional and interactive teaching for students and permanent training of practicioners of Universities involved in our project.

More over, interactive lessons in co-operation with Pain Centres of other countries are foreseen.