1. Pain as the fifth vital sign in Galicia: overcome challenge Mª Dolores Martín Rodríguez Quality Programs Manager Galician Health Service. Spain Lola.martin.rodriguez@sergas.es Copenhagen, 30 May 2012 WS 3: Improving pain management: Delivering results in best practice cooperation models

2. S trategic cores Professionals: our greatest asset Quality and Patient Safety Health and demands of citizens Rigorous and efficient management Modernization of infrastructure Technology and information Health sector as a creator of value STRATEGY SERGAS 2014 PUBLIC HEALTH CARE at the PATIENT’S SERVICE STRATEGY SERGAS 2014 PUBLIC HEALTH CARE at the PATIENT’S SERVICE

3. Galicia: Pain Care Situation 2010 Institutional Declaration Galician Health Ministry Institutional Declaration Galician Health Ministry

4. Implementation of the acute pain evaluation procedure in our hospitals: December 2011 Vital signs graph Pain 5th Vital Sign Vital signs graph Pain 5th Vital Sign

5. GALICIAN COMMISSION ON THE STRATEGY AGAINST PAIN Decree 60/2012 Director of Health Care President Autonomous Region of Galicia Scope To improve integral care policies on pain in the Galician Health Service Goal

6. President Director of Health Care President Director of Health Care Member 1 person attached to the department responsible for Health Care Member 1 person attached to the department responsible for Health Care Member 1 person attached to the department responsible for Patient Safety Member 1 person attached to the department responsible for Patient Safety Members 4 Physicians Members 4 Physicians Member 1 Pharmacist Member 1 Pharmacist Members 4 nurses Members 4 nurses Member 1 psychologist Member 1 psychologist Members 2 persons belonging to the Patient Advisory Council Members 2 persons belonging to the Patient Advisory Council Secretary Person attached to the department responsible for Patient Safety Secretary Person attached to the department responsible for Patient Safety Vice-president General Subdirector responsible for Patient Safety Vice-president General Subdirector responsible for Patient Safety Structure 14 members

7. REGISTER1 st Quarter2 nd Quarter3 rd Quarter4 th Quarter Average 2011 Inhospital Patients61 55361 17354 92159 184220 727 Patients with pain record on vital signs chart 11 319 (18.4%) 16 397 (26.8%) 16 589 (30.2%) 26 576 (44.9%) 71 235 (32.3%) Vital signs chart VAS record > 03 9055 0344 8277 60821 477 Qualitative record VAS> 03 9015 4095 5457 22322 075 Patients with pain record on vital signs chart VAS > 0 and Qualitative pain record **2 5112 4874 03111 335 ** 1st quarter data not available GACELA (2011) Integral Pain Care Results DATA SOURCE: GACELA. Vital signs chart record 2011

8. Integral Pain Care DATA SOURCE: GACELA. Vital signs chart record 2011 STANDARD ≥50% Average Galicia 2011 = 32.3

9. Integral Pain Care DATA SOURCE: GACELA. Vital signs chart record 2011 (N= 37 842)(N= 71 235) %

10. Integral Pain Care DATA SOURCE: GACELA. Vital signs chart record 2011

11. FemaleMale Age 0 - 1718 - 3940 - 59 ≥60TOTAL0 - 1718 -3940 - 59 ≥60TOTAL Patients VAS > 0 4193.4%436235.0%227618.3%540143.4%1245858.0%5646.3%112912.5%216124.0%516557.3%901942.0% Mild Pain 2393.3%261836.3%125417.4%309442.9%7 20558.2%3426.6%60311.6%120123.2%303958.6%518541.8% Moderate Pain 1633.6%153434.0%84418.7%196643.6%450758.7%1966.2%44314.0%78824.8%174655.0%317341.3% Severe Pain 172.3%21028.2%17823.9%34145.7%74653.0%263.9%8312.6%17226.0%38057.5%66147.0% Integral Pain Care Pain Intensity DATA SOURCE: GACELA. Vital Signs Chart Record 2011 Hospitals Patients Pain Intensity N= 21 477

12. Integral Pain Care DATA SOURCE: GACELA. Vital signs chart record 2011

13. Integral Pain Care DATA SOURCE: GACELA. Vital signs chart record 2011

14. Lines for Action 2012

15. Conclusions

16. THANK YOU FOR YOUR ATTENTION

17. Disclosure Statement of Financial Interest I, Mª Dolores Martín Rodríguez, DO NOT have a financial interest/arrangement or affiliation with one or more organizations that could be perceived as a real or apparent conflict of interest in the context of the subject of this presentation.