American pain society recommendations for improving the quality of acute and cancer pain management: American Pain Society Quality of Care Task Force.
BACKGROUND
The American Pain Society (APS) set out to revise and expand its 1995 Quality Improvement Guidelines for the Treatment of Acute Pain and Cancer Pain and to facilitate improvements in the quality of pain management in all care settings.


METHODS
Eleven multidisciplinary members of the APS with expertise in quality improvement or measurement participated in the update. Five experts from organizations that focus on health care quality reviewed the final recommendations. MEDLINE and Cumulative Index to Nursing and Allied Health Literature databases were searched (1994-2004) to identify articles on pain quality measurement and quality improvement published after the development of the 1995 guidelines. The APS task force revised and expanded recommendations on the basis of the systematic review of published studies. The more than 3000 members of the APS were invited to provide input, and the 5 experts provided additional comments. The task force synthesized reviewers' comments into the final set of recommendations.


RESULTS
The recommendations specify that all care settings formulate structured, multilevel systems approaches (sensitive to the type of pain, population served, and setting of care) that ensure prompt recognition and treatment of pain, involvement of patients and families in the pain management plan, improved treatment patterns, regular reassessment and adjustment of the pain management plan as needed, and measurement of processes and outcomes of pain management.


CONCLUSIONS
Efforts to improve the quality of pain management must move beyond assessment and communication of pain to implementation and evaluation of improvements in pain treatment that are timely, safe, evidence based, and multimodal.
Gordon
Debra B
DB
Department of Nursing, University of Wisconsin Hospital and Clinics, Madison 53792, USA. db.gordon@hosp.wisc.edu
Dahl
June L
JL
Miaskowski
Christine
C
McCarberg
Bill
B
Todd
Knox H
KH
Paice
Judith A
JA
Lipman
Arthur G
AG
Bookbinder
Marilyn
M
Sanders
Steve H
SH
Turk
Dennis C
DC
Carr
Daniel B
DB
D000208:Acute Disease; D006801:Humans; D009369:Neoplasms / Q000150:complications*; D017063:Outcome Assessment, Health Care; D010146:Pain / Q000209:etiology*; D059408:Pain Management; D010147:Pain Measurement; D010358:Patient Participation; D017410:Practice Guidelines as Topic; D012955:Societies, Medical; D017749:Total Quality Management; D016896:Treatment Outcome; D014481:United States