TY - JOUR
T1 - Management of acute pain in the postoperative setting
T2 - the importance of quality indicators
AU - Meissner, Winfried
AU - Huygen, Frank
AU - Neugebauer, Edmund A M
AU - Osterbrink, Jürgen
AU - Benhamou, Dan
AU - Betteridge, Neil
AU - Coluzzi, Flaminia
AU - De Andres, José
AU - Fawcett, William
AU - Fletcher, Dominique
AU - Kalso, Eija
AU - Kehlet, Henrik
AU - Morlion, Bart
AU - Montes Pérez, Antonio
AU - Pergolizzi, Joseph
AU - Schäfer, Michael
PY - 2018/1/2
Y1 - 2018/1/2
N2 - Despite the introduction of evidence-based recommendations for postoperative pain management (POPM), the consensus is that pain control remains suboptimal. Barriers to achieving patient-satisfactory analgesia include deficient knowledge regarding POPM among staff, lack of instructions, insufficient pain assessments and sub-optimal treatment. Effective monitoring of POPM is essential to enable policy makers and healthcare providers to improve the quality of care. Quality indicators (QIs) are quantitative measures of clinical practice that can monitor, evaluate and guide the quality of care provided to patients. QIs can be used to assess various aspects relating to the care process and they have proven useful in improving health outcomes in diseases such as myocardial infarction. In this commentary we critically analyze the evidence regarding the use of QIs in acute POPM based upon the experience of pain specialists from Europe and the USA who are members of the Change Pain Advisory Board. We also undertook a literature review to see what has been published on QIs in acute pain with the goal of assessing which QIs have been developed and used, and which ones have been successful/unsuccessful. In the hospital sector the development and implementation of QIs is complex. The nature of POPM requires a highly trained, multidisciplinary team and it is at this level that major improvements can be made. Greater involvement of patients regarding pain management is also seen as a priority area for improving clinical outcomes. Changes in structure and processes to deliver high-level quality care need to be regularly audited to ensure translation into better outcomes. QIs can help drive this process by providing an indicator of current levels of performance. In addition, outcomes QIs can be used to benchmark levels of performance between different healthcare providers.
AB - Despite the introduction of evidence-based recommendations for postoperative pain management (POPM), the consensus is that pain control remains suboptimal. Barriers to achieving patient-satisfactory analgesia include deficient knowledge regarding POPM among staff, lack of instructions, insufficient pain assessments and sub-optimal treatment. Effective monitoring of POPM is essential to enable policy makers and healthcare providers to improve the quality of care. Quality indicators (QIs) are quantitative measures of clinical practice that can monitor, evaluate and guide the quality of care provided to patients. QIs can be used to assess various aspects relating to the care process and they have proven useful in improving health outcomes in diseases such as myocardial infarction. In this commentary we critically analyze the evidence regarding the use of QIs in acute POPM based upon the experience of pain specialists from Europe and the USA who are members of the Change Pain Advisory Board. We also undertook a literature review to see what has been published on QIs in acute pain with the goal of assessing which QIs have been developed and used, and which ones have been successful/unsuccessful. In the hospital sector the development and implementation of QIs is complex. The nature of POPM requires a highly trained, multidisciplinary team and it is at this level that major improvements can be made. Greater involvement of patients regarding pain management is also seen as a priority area for improving clinical outcomes. Changes in structure and processes to deliver high-level quality care need to be regularly audited to ensure translation into better outcomes. QIs can help drive this process by providing an indicator of current levels of performance. In addition, outcomes QIs can be used to benchmark levels of performance between different healthcare providers.
KW - Acute Pain/drug therapy
KW - Consensus
KW - Europe
KW - Hospitals
KW - Humans
KW - Pain Measurement
KW - Pain, Postoperative/drug therapy
KW - Postoperative Period
KW - Quality Indicators, Health Care
KW - Quality of Health Care
M3 - Journal article
C2 - 29019421
SN - 0300-7995
VL - 34
SP - 187
EP - 196
JO - Current Medical Research and Opinion
JF - Current Medical Research and Opinion
IS - 1
ER -