Becker's ASC Review

72 Executive Briefing Dr. Hickman is hoping to use an even smaller amount of anesthetic with InfuTronix's newer pump. "I can take that 2 cc/hr infusion to a 2 cc intermittent bolus every 3 to 4 hours and still give the patient the ability to give themselves a demand bolus dose if they need it," Dr. Hickman said. "I think we'll even use less (local anesthetic) over four days than we currently use, minimizing our opioid exposure and with even less exposure for the nerves that have been treated with local anesthetic." Of the patients who undergo surgery, it's difficult to determine who could potentially become addicted to narcotics, Dr. Hickman said. "Our big thing is to get patients to use this pump for their pain management, and only take the narcotics if needed afterwards." Bolstering care quality with patient-reported outcomes "When patients are discharged, following up with a phone conversation goes a long way toward reassuring them that you understand what they're going through," Dr. Gadsden said. "It's important to offer support and encourage patients, so they continue physical therapy and achieve the positive outcome they desire." The Nimbus II PainPRO pump is complemented with new software, the AfterOp™ Mobile App that tracks patient- reported outcomes (PROs) throughout their treatment at no additional cost to the facility. Patients self-enroll in the software preoperatively, then answer five simple questions, so clinicians can gauge valuable information, including the patient's pain level, how many narcotics they are using, side effects they may be experiencing and how satisfied they are with their pain management. Patients answer the same five questions each day creating the opportunity for practices to use that data as a benchmark to determine if patients are getting the quality care that they need. The AfterOp™ platform can even be used to track and compare patient outcomes using different analgesia techniques like single shot blocks. "Nimbus automatically collects some of the data, in terms of how much local anesthetic is being used, how many times the patient is pushing the bolus button and correlates that with their reported pain scores," Dr. Gadsden said. "That offers us another different way to monitor how our patients are doing." While using this technology to report data on their interscalene catheters, Dr. Hickman found that patients at Andrews Institute were complaining of being too numb and feeling more pain on the first day. However, the same patients were satisfied with their pain on the second day. This new information led to the assumption that the initial block was causing patients to be very numb within the first 24 hours, and when they were transitioning to the catheter infusion using a more dilute local anesthetic concentration so not producing as intense of a block — they were noticing some pain until the infusion picked up. "After about two weeks of data with the AfterOp™ software, we realized this and changed our process then validated that the change was effective. We started doing the initial block with a less concentrated local anesthetic," Dr. Hickman said. "Therefore, the patients weren't quite as numb that first day, and their transition to the catheter infusion was a lot smoother. The patients actually reported less pain this way, even though it was less numb." A cost-effective pain management solution Boosting the reservoir capacity of the Nimbus II pain pump up to 1.5 liters, which can last up to five days, helps reduce the need for postoperative, oral opioid use and offers several economic benefits to healthcare organizations. "The bottom line is it's really helped me lower my infusion rates," said Dr. Hickman, who uses the pump to increase the duration of his patients' infusions after knee replacements from three days to four days. "We really want to get the patient over the hump where their need for opioids is greatly reduced, and we feel like four days greatly reduces their need for opioids after surgery. And perhaps best of all is that we can confirm that by using the AfterOP™ software to see that a patients' pain doesn't spike after the pain pump is finished. We finally have a method to track pain scores and opioid use all the way out to POD 5 without having to burden our nurses. It gives a lot of meaningful visibility into our patients' recovery that we didn't have before." If you can provide a pain-free experience with local anesthetic and avoid the use of opioids, it will naturally result in cost savings for the hospital, Dr. Gadsden said. Ultimately, that will prevent patients from having pain that causes readmissions and emergency room visits, which are a drain on the system — not to mention the societal and actual economic costs of the opioid crisis itself. From a more granular financial standpoint, Duke saved "well into the six figures" over its annual projection of total catheter volume with InfuTronix's solution, compared to its previous elastomeric pump, while also adding the improved functionality, according to Dr. Gadsden. "That was a huge cost-savings for our hospital," he said, "as well as getting that added patient satisfaction from the functionality." n NIMBUS PainPRO: THE FUTURE OF POST-OP PAIN PUMPS Nimbus PainPRO brings to market a new, cost effective, electronic pain pump that offers patients complete control of their pain therapy. Working together with KOLs, Nimbus adds cutting-edge features with electronic safeguards and a larger reservoir volume to deliver longer, more flexible and more effective opioid sparing therapies. Our goal is to optimize the efficiency of your ASC by wrapping a total solution around your pain pump outsourcing your pharmacy burden, capturing patient reported outcomes and offering cost-effective strategies to make Nimbus a more budget friendly solution for your business. Join Nimbus PainPRO, the future of pain control.

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