Publications
APS Bulletin • Volume 15, Number 4, Fall 2005
Innovations in Practice
APS 2005 Recommendations for Improving the Quality of Acute and Cancer Pain Management
Debra Gordon, MS RN
Two years of work by the APS Quality of Care Task Force culminated in July with the publication of updated recommendations for improving the quality of acute and cancer pain (Gordon et al., 2005). These recommendations represent a revision and expansion of the 1995 Quality Improvement (QI) Guidelines (APS, 1995) and are intended to facilitate improvements in the quality of pain management in all care settings. They were developed from a systematic review of the literature on QI in pain management as well as expert consensus. In addition, comments were incorporated from five experts from organizations that focus on healthcare quality including the American Medical Association, the Joint Commission on Accreditation of Healthcare Organizations, and the National Committee on Quality Assurance.
It is essential that efforts to improve the quality of pain management move beyond assessment and communication of pain to implementation and evaluation of improvements in pain treatment that are timely, safe, evidence-based, and multimodal. Improving treatment patterns is a key component of the new recommendations, which emphasize that all care settings should formulate a structured, multilevel systems approach (sensitive to the type of pain and setting of care) that focuses on five primary areas: (1) prompt recognition and treatment of pain, (2) involvement of patients in the pain management plan, (3) improved treatment patterns, (4) regular reassessment and adjustment of the pain management plan as needed, and (5) measurement of processes and outcomes of pain management.
Integrating new knowledge and behaviors into day-to-day pain management practice is a challenging but essential process. Novel design and testing of new ways to facilitate communication, treatment, and continuity across care settings continues to be needed; we hope the revised recommendations will be useful in those endeavors.
Copies of the 2005 QI recommendations are available by mail from the APS national office, which you can contact at info@ampainsoc.org.
References
American Pain Society. (1995). Quality improvement guidelines for the treatment of acute pain and cancer pain. Journal of the American Medical Association, 274, 1874-1880.
Gordon, D. B., Dahl, J. L., Miaskowski, C., McCarberg, B., Todd, K. H., Paice, J. A., Lipman, A., Bookbinder, M., Sanders, S. H., Turk, D. C., Carr, D. (2005). American Pain Society recommendations for improving the quality of acute and cancer pain management. Archives of Internal Medicine, 165, 1574-1580.