title: Data-driven interdisciplinary interventions to improve inpatient pain management.
abstract: Pain during hospitalization and dissatisfaction with pain management are common. This project consisted of 4 phases: identifying a pain numeric rating scale (NRS) metric associated with patient satisfaction, identifying independent predictors of maximum NRS, implementing interventions, and evaluating trends in NRS and satisfaction. Maximum NRS was inversely associated with favorable pain satisfaction for both efficacy (n = 4062, χ(2) = 66.2, P < .001) and staff efforts (n = 4067, χ(2) = 30.3, P < .001). Independent predictors of moderate-to-severe maximum NRS were younger age, female sex, longer hospital stay, admitting department, psychoactive medications, and 10 diagnostic codes. After interventions, moderate-to-severe maximum NRS declined by 3.6% per quarter in 2010 compared with 2009. Satisfaction data demonstrated improvements in nursing units meeting goals (5.3% per quarter, r (2) = 0.67) and favorable satisfaction answers (0.36% per quarter, r (2) = 0.31). Moderate-to-severe maximum NRS was an independent predictor of lower likelihood of hospital discharge (likelihood ratio = 0.62; 95% confidence interval = 0.61-0.64). Targeted interventions were associated with improved inpatient pain management.
authors.affiliation: Mount Sinai School of Medicine, New York, NY 10029, USA. david.reich@mountsinai.org
authors.forename: David L
authors.initials: DL
authors.lastname: Reich
authors.forename: Carol
authors.initials: C
authors.lastname: Porter
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Levin
authors.forename: Hung-Mo
authors.initials: HM
authors.lastname: Lin
authors.forename: Kash
authors.initials: K
authors.lastname: Patel
authors.forename: Robert
authors.initials: R
authors.lastname: Fallar
authors.forename: Stelian
authors.initials: S
authors.lastname: Serban
authors.forename: Emily
authors.initials: E
authors.lastname: Chai
authors.forename: Ira S
authors.initials: IS
authors.lastname: Nash
authors.forename: Maria
authors.initials: M
authors.lastname: Vezina
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Silverstein
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007297:Inpatients / Q000523:psychology / Q000706:statistics & numerical data; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods* / Q000592:standards; D010147:Pain Measurement / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D010348:Patient Care Team; D017060:Patient Satisfaction; D058996:Quality Improvement; D012737:Sex Factors; D055815:Young Adult