title: Implementation of the quality management system improves postoperative pain treatment: a prospective pre-/post-interventional questionnaire study.
abstract: BACKGROUND
  An organizational approach is proposed as an immediate solution for improving postoperative pain (POP) management. The aim was to evaluate the clinical effectiveness of a quality management system (QMS), based on procedure-specific, multimodal analgesic protocols, modified to meet the individual patients' requirements.
  
  
  METHODS
  Patients from the orthopaedic, gynaecological, visceral, and trauma surgery departments of the university hospital were involved in two prospective surveys. Survey 1 was performed at baseline and survey 2 was performed after the implementation of QMS within an interval of 1 year. The patients were asked to report pain intensity on the visual rating scale, incidence of analgesia-related side-effects, and incidence of pain interference with the items of life quality and their satisfaction with the treatment of POP.
  
  
  RESULTS
  Patients from Survey 2 (n=251) reported 25-30% less pain than those from Survey 1 (n=269) (P<0.0001). Nausea was reported by 40% of the patients from Survey 1 vs 17% from Survey 2, vomiting by 25 vs 11% and fatigue by 76% in Survey 1 vs 30% in Survey 2 (P<0.0001). Life quality and patients' satisfaction improved in Survey 2 vs Survey 1 (P<0.001).
  
  
  CONCLUSIONS
  The implementation of QMS allowed the reduction in POP intensity with a simultaneous decrease in analgesia-related side-effects. This has led to an increased quality of life and patient satisfaction.
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, University Medicine of Greifswald, Greifswald, Germany. taras@uni-greifswald.de
authors.forename: T I
authors.initials: TI
authors.lastname: Usichenko
authors.forename: I
authors.initials: I
authors.lastname: Röttenbacher
authors.forename: T
authors.initials: T
authors.lastname: Kohlmann
authors.forename: A
authors.initials: A
authors.lastname: Jülich
authors.forename: J
authors.initials: J
authors.lastname: Lange
authors.forename: A
authors.initials: A
authors.lastname: Mustea
authors.forename: G
authors.initials: G
authors.lastname: Engel
authors.forename: M
authors.initials: M
authors.lastname: Wendt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018712:Analgesics, Non-Narcotic / Q000009:adverse effects / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018710:Pain Clinics; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D010348:Patient Care Team / Q000458:organization & administration; D017060:Patient Satisfaction; D011446:Prospective Studies; D011785:Quality Assurance, Health Care; D058996:Quality Improvement / Q000458:organization & administration*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid