EP173 A quality improvement initiative to reduce delays in pain management for chest trauma patients at Vancouver general hospital

<h3>Background and Aims</h3> Vancouver General Hospital (VGH) is a trauma centre that receives &gt;250 patients annually with traumatic chest injuries. The trauma service consults the anesthesia perioperative pain service (POPS) through an institutional referral pathway for high-risk patients. We identified frequent delays to POPS involvement, leading to inadequate pain control, avoidable opioid side effects, increased risk of delirium and pulmonary compromise. We aimed to reduce the time from trauma admission to POPS assessment or intervention by 15% in high-risk chest trauma patients admitted under trauma services at VGH. <h3>Methods</h3> Data was collected from a departmental patient database and hospital electronic medical records from November 2022 to April 2024, including times of admission, POPS consultation and POPS intervention. The time intervals between each were calculated. Discussions with POPS and trauma physicians and nurses resulted in introduction of a Chest Trauma Referral Pathway educational video in February 2024 embedded into house staff orientation materials. <h3>Results</h3> Baseline data demonstrated excessive delays in optimal care: on average 15.2 hours from admission to POPS consultation, 18.0 hours to intervention, and 2.6 weeks between missed consultations (table 1). After video implementation, there was a consistent shift in the time from admission to consultation sustained for 13 referrals (figure 1). The average time from admission to consultation decreased to 4.2 hours (-72.4%), and to intervention to 8.2 hours (-54.4%). <h3>Conclusions</h3> Introduction of a Chest Trauma Referral Pathway video successfully reduced the time patients with traumatic chest injuries were waiting for pain management (by 72.4% to POPS consultation, and by 54.4% to POPS intervention).