INSTITUTIONALIZING EFFECTIVE PAIN MANAGEMENT PRACTICES

Questions and Answers
A project of the Massachusetts Pain Initiative.

UPDATE: In 2007, MassPI was awarded a grant from the Alliance of State Pain Initiatives for a new change project that will target home care agencies, long term care facilities and small community hospitals. For additional information, contact carol.curtiss@verizon.net.

What are the goals of the project?
The first objective is to educate teams of key individuals in healthcare organizations about effective pain management. Recognizing, however, that education of individuals does not automatically bring practice change, the second objective of the project is to help the team members understand how to overcome their system’s barriers to good pain management practices.

Who will participate?
All home health agencies and small community hospitals in Massachusetts were invited to participate through a packet mailed in mid-February, 2003. Up to twenty-five facilities can be accommodated for this program.
The twenty-two agencies and hospitals who elected to participate in this program are:

1. Chicopee VNA Chicopee, MA
2. Cooley Dickinson Hospital Northampton, MA
3. Emerson Hospital Concord, MA
4. Interim Healthcare West Springfield, MA
5. Lee Regional VNA Lee, MA
6. Mount Auburn Hospital Cambridge, MA
7. Northeast Health System Beverly, MA
8. Norwell VNA Norwell, MA
9. Quaboag VNA & Hospice Palmer, MA
10. Cambridge Health Alliance Cambridge, MA
11. Wing Memorial Hospital Palmer, MA
12. Caritas Carney Hospital Dorchester, MA
13. Caritas St. Elizabeth’s Medical Ctr Boston, MA
14. Diversified VNA Fitchburg, MA
15. Falmouth Hospital Falmouth, MA
16. Faulkner Hospital Boston, MA
17. Kindred Hospital Boston Boston, MA
18. Saints Memorial Medical Center Lowell, MA
19. Bayada Nurses, Inc Hyannis, MA
20. VNA Boston Hyde Park, MA
21. VNA Care Network Worcester, MA
22. VNA Southeastern Mass, Inc Fall River, MA
Similar programs have been offered and completed by eight other state pain initiatives.

What were the first steps of the project?
As a first step in the program, Project Coordinator met with each team to initiate a baseline review of the agency’s pain management practices, and to demonstrate how to collect the patient surveys required for this project. The next step was explained to be a two day conference.

What were some details about the first conference?
Each team attended a two-day conference in Auburn, Massachusetts on June 3-4, 2003. The first day combined plenary sessions and workshops on pain assessment, the pharmacologic management of pain, and communication strategies. During day two, the teams reviewed and reinforced the concepts from day one, and explored non-pharmacologic pain strategies. At the conclusion of the conference, each team assessed and prioritized agency needs, set goals, and developed an action plan to establish effective pain management practices in your agency. The speakers for this conference were locals Carol Curtiss, RN, MSN, and Anne Marie Kelly, BSN, RN C, and from Wisconsin, Karen Stevenson, RN, MS. Workshop leaders were locals Carol Curtiss, RN, MSN, Judy Dyer, RN, MSN, MA, CS, CHPN, Ann Marie Harootunian, RN, MS, FNP, Anne Marie Kelly, BSN, RNC, Nancy Kowal, MS, ANP.

What happens after the first conference?
The teams will implement their action plans, and then develop a poster presentation about their activities. Team members are encouraged to make this poster useful for future presentation to those that survey each agency for accreditation or licensure. Each team will also present this poster at the second educational conference, which will be a one day session on November 6, 2003, in Marlborough, MA. The content of this conference will be determined from the feedback from the teams at the first meeting. Each team will also be given materials to collect 30 more patient surveys. The Massachusetts Pain Initiative Coordinator, Amy Goldstein, in the Natick office of American Cancer Society, is coordinating this project.

How will home health agencies and small community hospitals benefit from participating in the project?
Organizations will develop an increased level of confidence in their pain management practices and in improving outcomes for the care of patients in pain. The opportunity for an exchange of information with colleagues developing similar programs and working with similar strategies will provide an avenue for and support of the process of change. Each organization will have the opportunity to develop quality improvement projects that can be used for program development and to meet the requirements of surveyors and accrediting bodies. Finally, the Joint Commission on the Accreditation of Health Care Organizations has revised its standards to include an emphasis on pain assessment and treatment. This program is designed to help you meet the changes in the standards.

What happens to the patient survey data?
The national office coordinating this project will enter and analyze data under strict guidelines to maintain confidentiality. Each team will be sent summary reports comparing their organization’s results to the overall project results.

What are the costs associated with the project?
The actual cost per agency for this project is more than $3,500. Support from The Project on Death in America, the American Alliance of Cancer Pain Initiatives, American Cancer Society and Stratford Foundation allowed the reduced registration fee of $350 per agency.

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