A systematic assessment and monitoring intervention to improve pain management and quality reporting among home hospice patients

Journal of Pain and Symptom Management
J Cameron MuirPerry G Fine

Abstract

Validated and reproducible means to systematically improve pain documentation and outcomes in home-based hospice populations are generally lacking. This paper describes a novel, electronic medical record (EMR)-embedded pain monitoring and management program for home-based hospice patients. Pain relief was measured by patients' self-defined pain within 48 hours of initiating care, recorded on a 0-10 pain scale. The Pain Continuous Quality Improvement Program (PCQIP) consisted of EMR enhancements, staff engagement and training, and incentivizing techniques. The PCQIP effectively improved documentation of pain and reduced the prevalence of unresolved problematic pain (e.g., lower average pain score ratings, decrease in patients reporting problematic pain after 48 hours of initiating care). Integrating the upgraded EMR system into routine practice and workflow was critical to facilitating rapid recognition of escalating pain and inadequate pain management as well as allowing improving monitoring of patient outcomes and staff performance.

References

Jun 17, 2003·Journal of the American Medical Directors Association·Victoria WardenLadislav Volicer
Jun 21, 2011·Medical Care·Melissa D A CarlsonElizabeth H Bradley
Aug 2, 2013·Journal of the American Medical Informatics Association : JAMIA·Terrence Y TianDaren R Anderson
Mar 19, 2014·Journal of Pain and Symptom Management·Nan Tracy ZhengShulamit L Bernard
Jan 15, 2015·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·David A FishbainJinrun Gao
Jan 4, 2017·Journal of Pain and Symptom Management·Jacob N HunnicuttKate L Lapane

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Citations

Aug 10, 2020·Journal of Hospice and Palliative Nursing : JHPN : the Official Journal of the Hospice and Palliative Nurses Association·Rachael Brown Kincaid
Jun 28, 2019·Journal of Pain and Symptom Management·Matthew G KestenbaumJ Cameron Muir

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