Patients with complex pelvic pain experience multiple barriers to care given the know-how, individualized coordination, and time required to truly address their needs. From the provider perspective, these complex patients need time out of proportion to reimbursement, thereby crowding the remainder of the day or spilling into personal time. Burnout has been shown to be a factor in physician depression as well as poor medical outcomes in their patients (1).  In 2015, recognizing 1) the need for better care of persons with pelvic pain yet 2) resistance among skilled providers to accept more patients with this diagnosis, we launched a navigated intake program harnessing the efficiencies of collaboration. In this low budget multidisciplinary program involving 11 specialties, referrals for pelvic pain were intercepted by our nurse navigator. She 1) screened need for concurrent consults 2) stewarded completion of extensive presenting symptoms, medical history, validated measures, and prior trials of therapy, and 3) conducted record accession. Data was input as discrete, queriable data points by a seasoned transcriptionist into a custom database integral to the electronic medical record. At the time of initial encounter with the provider, patients’ documentation was fully pre-populated for the visit, and concurrent needs had already been triaged. As patients with pelvic pain often see multiple specialists, the benefits of the intake efficiencies were multiplied by number of providers. The goal of the program was to allow each provider to meet the modular needs of the specialty within a thorough, coordinated care structure, decreasing frustration for the patient and physician alike. The current project reports the physicians’ assessment of the program benefits.

IRB approval was obtained to send a non-anonymous questionnaire to providers regarding ease of management, timed saved and perceived patient benefit.

Twenty two of the twenty eight providers active in the program responded to our survey (81 % response rate). There were an additional 9 providers who were initially identified in the program design but were not active, e.g. an interventional radiologist who had never seen a patient through the program (if this non-active group were included the response rate would be 61%). Of active providers, there was an 81% response rate. Responses regarding impact of the program are reported in Table 1. Overall physicians deeply appreciated the value of this structure.

Overall physicians deeply appreciated the value of this navigated intake structure.  Though providers did not feel that it resulted in significantly quicker appointments, physicians felt that the system allowed for more meaningful interactions with their patients.   The physicians in the study felt as though the structure resulted in their patients recieving a higher quality care and more support outside of their appointments, which in turn increase provider satisfaction.

The program presented here is an outside the box, low budget, common-sense program designed to address two major issues impacting provider satisfaction: 1) provider fatigue and 2) the ability to take pride in high quality care. In addition, an academic database was built inherent to the clinical data. Overall, the majority of providers reported improved ease, time saved, thoroughness, satisfaction, and willingness to see these complex patients, as well as the perception that the program improved care of the patients. Comprehensive financial analysis of the program and patient reported outcomes are underway and will be reported in the subsequent analyses.

Ann Surg. 2010 Jun;251(6):995-1000.