TY - JOUR
T1 - Data-Driven Interdisciplinary Interventions to Improve Inpatient Pain Management
AU - Reich, David L.
AU - Porter, Carol
AU - Levin, Matthew A.
AU - Lin, Hung Mo
AU - Patel, Kash
AU - Fallar, Robert
AU - Serban, Stelian
AU - Chai, Emily
AU - Nash, Ira S.
AU - Vezina, Maria
AU - Silverstein, Jeffrey H.
PY - 2013/5
Y1 - 2013/5
N2 - Pain during hospitalization and dissatisfaction with pain management are common. This project consisted of 4 phases: identifying a pain numeric rating scale (NRS) metric associated with patient satisfaction, identifying independent predictors of maximum NRS, implementing interventions, and evaluating trends in NRS and satisfaction. Maximum NRS was inversely associated with favorable pain satisfaction for both efficacy (n = 4062, χ2 = 66.2, P <.001) and staff efforts (n = 4067, χ2 = 30.3, P <.001). Independent predictors of moderate-to-severe maximum NRS were younger age, female sex, longer hospital stay, admitting department, psychoactive medications, and 10 diagnostic codes. After interventions, moderate-to-severe maximum NRS declined by 3.6% per quarter in 2010 compared with 2009. Satisfaction data demonstrated improvements in nursing units meeting goals (5.3% per quarter, r2 = 0.67) and favorable satisfaction answers (0.36% per quarter, r2 = 0.31). Moderate-to-severe maximum NRS was an independent predictor of lower likelihood of hospital discharge (likelihood ratio = 0.62; 95% confidence interval = 0.61-0.64). Targeted interventions were associated with improved inpatient pain management.
AB - Pain during hospitalization and dissatisfaction with pain management are common. This project consisted of 4 phases: identifying a pain numeric rating scale (NRS) metric associated with patient satisfaction, identifying independent predictors of maximum NRS, implementing interventions, and evaluating trends in NRS and satisfaction. Maximum NRS was inversely associated with favorable pain satisfaction for both efficacy (n = 4062, χ2 = 66.2, P <.001) and staff efforts (n = 4067, χ2 = 30.3, P <.001). Independent predictors of moderate-to-severe maximum NRS were younger age, female sex, longer hospital stay, admitting department, psychoactive medications, and 10 diagnostic codes. After interventions, moderate-to-severe maximum NRS declined by 3.6% per quarter in 2010 compared with 2009. Satisfaction data demonstrated improvements in nursing units meeting goals (5.3% per quarter, r2 = 0.67) and favorable satisfaction answers (0.36% per quarter, r2 = 0.31). Moderate-to-severe maximum NRS was an independent predictor of lower likelihood of hospital discharge (likelihood ratio = 0.62; 95% confidence interval = 0.61-0.64). Targeted interventions were associated with improved inpatient pain management.
KW - analgesia
KW - pain management
KW - patient satisfaction
KW - quality management
UR - https://www.scopus.com/pages/publications/84878056878
U2 - 10.1177/1062860612457425
DO - 10.1177/1062860612457425
M3 - Article
C2 - 22942123
AN - SCOPUS:84878056878
SN - 1062-8606
VL - 28
SP - 187
EP - 195
JO - American Journal of Medical Quality
JF - American Journal of Medical Quality
IS - 3
ER -