Implementation and evaluation of a quality improvement process to improve pain management in a hospice setting

Abstract

The purpose of this article is to describe the implementation and evaluation of a quality improvement process to improve pain management in a hospice setting. A retrospective chart audit of 702 patient visits pre- and 536 patient visits post-implementation of quality improvement strategies measured five aspects of pain management: complaints of pain, severity of pain, changes in patient's pain medication regime required, patient and family teaching, and use of complementary therapies. Of these measures a significant change was found in the documentation of pain assessment, recognition of changes required in the medication regime, and patient and family teaching.

American Pain Society Recommendations for Improving the Quality of Acute and Cancer Pain Management

“…Implementation of the 1995 American Pain Society (APS) Quality Improvement Guidelines for the Treatment of Acute Pain and Cancer Pain 16 effected improvements in pain assessment [17][18][19][20][21] and prescribing practices, [22][23][24] with less effect on patient outcomes. [25][26][27] Quality improvement (QI) expertise, in pain manage-ment and other areas of health care, has grown, allowing new insights into the key elements necessary for success.…”

Using Quality Improvement to Enhance Research Readiness in Palliative Care

“…Continuous effort to improve quality of care is an essential feature of the initiation and ongoing development of palliative and endof-life (P/EOL) care programs (Morita et al, 2004;Stewart, Teno, Patrick, & Lynn, 1999). Quality improvement initiatives in P/EOL care have been reported, particularly in the area of pain management (Comley & DeMeyer, 2001;Duggleby & Alden, 1998) and system redesign (Thomas & Quinn, 2002). Yet little consideration has been given to how quality improvement could be viewed not only as a mechanism to improve health system processes and practices within organizations (Beyea & Nicoll, 1998;Casarett, Karlawish, & Sugarman, 2000) but also as a strategy to introduce research concepts and the value of research to clinical staff and health administrators.…”