Reliable predictors of pain were identified by surveying hospital patients throughout their stays about the severity of their pain and their levels of satisfaction with how their pain was managed by hospital staff in a study, “Does Patient Perception of Pain Control Affect Patient Satisfaction Across Surgical Units in a Tertiary Teaching Hospital?” conducted by researchers from the Mount Sinai School of Medicine that was published online in the American Journal of Medical Quality. Interdisciplinary teams who treated patients used these data to identify patients at higher risk for pain before or immediately upon their admission and to create and implement intervention plans that resulted in patients reporting lower levels of pain and higher levels of satisfaction with their pain management.
Patients who identified their pain during their hospital admission as moderate or severe were more likely to be younger, female, admitted for longer hospital stays, or using psychoactive medications. The level of pain was found to vary with the department of the treating physician.
Patients who were treated by surgical services reported greater pain severity. Before the predictors were identified, patients who underwent lower extremity joint replacement in the department of orthopedics reported an average pain level of 5 on a scale of 0 to 10 on the first day after surgery. After analyzing the predictive data, the interdisciplinary team introduced new protocols that altered the types of oral and intravenous medications given and allowed use of epidural morphine outside of intensive care settings. The average reported pain level decreased to 3.
Using the results of the predictive model, an interdisciplinary pain management team developed and implemented practice-based and evidence-based interventions. Overall, reported pain levels decreased by 3.6% per quarter in 2010 compared with 2009, and patient satisfaction increased. In 5 of 11 departments, the decrease in pain severity was statistically significant in 2010 compared with 2009. No department reported that their patients experienced increased pain during that time.
Institutions that use their available data and take an interdisciplinary approach to pain management can be successful in improving the patient experience, the researchers suggested.