title: Nominal group technique: a brainstorming tool for identifying areas to improve pain management in hospitalized patients.
abstract: BACKGROUND
  Pain management in hospitalized patients remains a priority area for improvement; effective strategies for consensus development are needed to prioritize interventions.
  
  
  OBJECTIVE
  To identify challenges, barriers, and perspectives of healthcare providers in managing pain among hospitalized patients.
  
  
  METHODS
  Qualitative and quantitative group consensus using a brainstorming technique for quality improvement-the nominal group technique (NGT).
  
  
  METHODS
  One medical, 1 medical-surgical, and 1 surgical hospital unit at a large academic medical center.
  
  
  METHODS
  Nurses, resident physicians, patient care technicians, and unit clerks.
  
  
  METHODS
  Responses and ranking to the NGT question: "What causes uncontrolled pain in your unit?"
  
  
  RESULTS
  Twenty-seven health workers generated a total of 94 ideas. The ideas perceived contributing to a suboptimal pain control were grouped as system factors (timeliness, n = 18 ideas; communication, n = 11; pain assessment, n = 8), human factors (knowledge and experience, n = 16; provider bias, n = 8; patient factors, n = 19), and interface of system and human factors (standardization, n = 14). Knowledge, timeliness, provider bias, and patient factors were the top ranked themes.
  
  
  CONCLUSIONS
  Knowledge and timeliness are considered main priorities to improve pain control. NGT is an efficient tool for identifying general and context-specific priority areas for quality improvement; teams of healthcare providers should consider using NGT to address their own challenges and barriers.
authors.affiliation: Saint Joseph Hospital, Section of Hospital Medicine, London, Kentucky, USA.
authors.forename: Adolfo
authors.initials: A
authors.lastname: Peña
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Estrada
authors.forename: Debbie
authors.initials: D
authors.lastname: Soniat
authors.forename: Benjamin
authors.initials: B
authors.lastname: Taylor
authors.forename: Michael
authors.initials: M
authors.lastname: Burton
mesh_terms: D001291:Attitude of Health Personnel; D006282:Health Personnel / Q000523:psychology / Q000592:standards*; D006760:Hospitalization; D006801:Humans; D059408:Pain Management / Q000379:methods* / Q000592:standards*; D058996:Quality Improvement / Q000592:standards*