Frequent hospitalizations and emergency room (ED) visits can have an impact on the quality of care and quality of life of patients with chronic pain complaints. For the patients with sickle cell disease (SCD), pain is the most common reason for having multiple ED visits and hospitalizations. Poor pain control can be the results of multiple system problems and/or personal difficulties that are not addressed outside of the acute care setting. In this situation, quality of care is affected because access to community care is not well coordinated with the acute care setting. The frequency of hospital admissions, the multiple times the patients visit the ED and the increased in no-show clinic visits are the variables that was reviewed. The effects of these variables were the focus of this project in addition to, what is required to impact change in the behavior of the clinicians and patients and how a call system can enhance compliance to clinic visits. Carr defines pain as “an unpleasant sensory and emotional experience associated with actual and potential tissue damage”. The classifications of pain are location, severity, intensity and duration. These classifications of pain affect the patient with SCD. Pain is considered a hallmark of SCD and the number one reason for patients to seek medical care. The type of pain most commonly encountered by SCD patients of all ages is referred to as acute painful episodes or more commonly as painful crisis. In January 2009, the Comprehensive Sickle Cell Centers (CSCC) across the nation. This CSCC in the New York area operated for 20 years and provided comprehensive services to the local community and the metropolitan area. The population has since used the services of the emergency room and inpatient beds to compensate for what is no longer available. In an effort to enhance the compliance with the clinic visits the pain management clinician believes a change in practice behavior can impact that change. Engel’s biopsychosocial model is a generated model or an approach that posits that biological, psychological and social factors that all play a significant role in human functioning in the context of disease or illness. The biological component of the biopsychosocial model seeks to understand how the cause of the illness stems from the functioning of the individual’s body. The psychological component of the biopsychological model looks for potential psychological causes for a health problem such as self-control. Pain, being a health problem that affects a patient’s psychologically. The design for the project was a quantitative correlational model that measured the number of times the patients kept their scheduled clinic appointments against the number of times they visited the ED and the number of hospitalizations in a sixty-day period, comparing the findings with any sixty-day period before the project. The outcome was to identify if the clinician’s practice change impacted on the number of ED visits. The objective was to evaluate the clinician’s compliance in the change in practice behavior with the call system. The outcome was that a total of 2.75 fewer ED visits were made and 0.9167 fewer hospital admissions.
