title: Applying quality improvement methods to implement a measurement system for chronic pain-related disability.
abstract: OBJECTIVE
  This article describes the application of quality improvement methodology to implement a measurement tool for the assessment of functional status in pediatric patients with chronic pain referred for behavioral intervention.
  
  
  METHODS
  The Functional Disability Inventory (FDI), a validated instrument for assessment of pain-related disability, was chosen as the primary clinical outcome measure. Using improvement science methodology, PDSA (Plan-Do-Study-Act) cycles were run to evaluate: (a) regular FDI administration, (b) two administration methods, (c) regular patient feedback, and (d) documentation methods.
  
  
  RESULTS
  Within 1 month, psychologists were administering the FDI at least 80% of the time to patients. A high level of reliability using two administration methods (92.8%) was demonstrated. The FDI was feasible to integrate into clinical practice. Modifications to electronic records further enhanced clinician reliability of documentation.
  
  
  CONCLUSIONS
  Quality improvement methods are an innovative way to make process changes in pediatric psychology settings to dependably gather and document evidence-based patient outcomes.
authors.affiliation: Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA. anne.lynch-jordan@cchcm.org
authors.forename: Anne M
authors.initials: AM
authors.lastname: Lynch-Jordan
authors.forename: Susmita
authors.initials: S
authors.lastname: Kashikar-Zuck
authors.forename: Lori E
authors.initials: LE
authors.lastname: Crosby
authors.forename: Wendi L
authors.initials: WL
authors.lastname: Lopez
authors.forename: Beverly H
authors.initials: BH
authors.lastname: Smolyansky
authors.forename: Irina S
authors.initials: IS
authors.lastname: Parkins
authors.forename: Carolyn P
authors.initials: CP
authors.lastname: Luzader
authors.forename: Abigail
authors.initials: A
authors.lastname: Hartman
authors.forename: Shanna M
authors.initials: SM
authors.lastname: Guilfoyle
authors.forename: Scott W
authors.initials: SW
authors.lastname: Powers
mesh_terms: D000293:Adolescent; D001521:Behavior Therapy; D002648:Child; D002908:Chronic Disease; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain / Q000175:diagnosis*; D059408:Pain Management; D010147:Pain Measurement / Q000379:methods*; D012720:Severity of Illness Index; D017749:Total Quality Management / Q000379:methods*