1. Managing Pain and The Patients’ Perspective: A Collaborative Approach
Beth Israel Deaconess Medical Center
Introduction/Problem
BIDMC’s HCAHPS patient satisfaction scores related to pain management illustrated opportunity for improvement.
The hospital fell outside of the target zone for payer reimbursements for this metric since FY2014.
Patient feedback indicates opportunity exists with Staff Attentiveness Patient Perception of Staff Attentiveness and Response
12 Reisman agreed to be one of three inpatient units to pilot pain management initiatives in FY2016, with a plan to spread successful initiatives to additional inpatient units accordingly.
Aim/Goal
The Interventions
By improving pain management patient satisfaction results for 12 Reisman, in combination with the results of other piloting inpatient units, it will impact BIDMC’s overall pain management patient satisfaction scores and lead to a 2% increase by end of the fiscal year
Design and Implementation of Staff Survey to assess educational needs related to pain management.
Inclusion of 2 Pain-related Quality Measures as part of the Decision Management System (DMS)
Based on learning opportunities identified through the staff surveys, patient satisfaction data and documentation audits, pain management education tools were created including:
Development of Pain Management Algorithm for Nursing
Scripting for Patient Education re: Blocks and Pain Plan
Development of educational tool re: pain assessment/ reassessment
Nursing Education was rolled out in April 2016 via in-person small group sessions
As part of the orientation process to 12R, new nursing staff now attend the Total Joint Replacement Class
During the Fall of 2016, Rosenberg 6 and 12 Reisman nursing teams created and implemented a patient education tool for staff to use when communicating with patients about pain management. (This is introduced to Total Joint Replacement patients during their PreOp class.)
Results/Progress to Date
Pain Assessment Documentation
Assessment (Pain Score) documented within 15 minutes of med. administration?
Reassessment (Pain Score) documented within
20-45 mins Post-IV or mins Post-PO medication administration?
The Team
Gina Murphy, RN, MSN, 12R
Jenny Barsamian, RN, MSN, 12R
Caroline Torney, RN, BSN, 12R
Molly MacKay, RN, BSN, 12R
Danielle Francisco, RN, BSN, 12R
Phyllis West, MSN, RN, ACN
Deb Stepanian, Health Care Quality
12R Nursing Staff
Pre-Education
Post-Education
Post-
eFlowsheet
Rollout
Pre-Education
Post-Education
Post-
eFlowsheet
Rollout
Discharge Date
By the end of CY16, 12 Reisman gained a 2.2% increase in their Overall Pain Management Score, advanced by a 3.5% increase of patient’s responding staff ‘always’ did everything to help with their pain and 1% boost for patient’s pain ‘always’ well-controlled.
Gina Murphy, RN, MSN, Nurse Director,

2. Managing Pain and The Patients’ Perspective: A Collaborative Approach
Beth Israel Deaconess Medical Center
More Results/Progress to Date
Staff Survey Response: I routinely discuss a plan for pain control with my
total joint replacement patients at the start of every shift.
Lessons Learned
Next Steps
Improved patient satisfaction with pain management
Increased opportunities to help set expectations with patients
Enhanced knowledge of staff
Greater access to patient teaching tools
Introduced new opportunities for cross-departmental teamwork
Sustain
Revisit DMS Metrics
Continue auditing
Educate new staff, refresh current staff
Share
Mentor other units in the design of their own pain management improvement work
Gina Murphy, RN, MSN, Nursing Director,