title: Evaluation of the performance improvement CME paradigm for pain management in the long-term care setting.
abstract: OBJECTIVE
  A performance improvement continuing medical education (PI CME) activity was designed to assist clinicians with accurately identifying and appropriately managing persistent pain in long-term care facility (LTCF) residents.
  
  
  METHODS
  Volunteer LTCFs participated in a three-stage PI CME model consisting of: 1) baseline assessment, 2) implementation of practice improvement interventions, and 3) reassessment. Expert faculty chose performance measures and interventions for the activity. A champion was designated ateach LTCF to collect resident charts and enter data into an online database.
  
  
  METHODS
  Eight LTCFs located across the United States participated in the activity.
  
  
  METHODS
  Fifty resident charts were randomly selected by each LTCF champion (25 for stage 1 and 25 for stage 3); a total of 350 charts were reviewed.
  
  
  METHODS
  In addition to a toolkit containing numerous performance improvement resources, an in-service meeting led by an expert faculty member was conducted at each LTCF.
  
  
  METHODS
  Stage 3 data were collected 6 weeks after implementation of interventions and compared with stage 1 baseline data to measure change in performance.
  
  
  RESULTS
  Aggregate data collected from seven LTCFs completing the PI CME activity through stage 3 revealed improvements from baseline in four of five performance measures.
  
  
  CONCLUSIONS
  This CME activity allowed for collection of data demonstrating performance improvement in persistent pain management. The tools used as part of the intervention (available at http://www.achlpicme.org/LTC/toolkit) may help other clinicians enhance their management of LTCF residents with persistent pain.
authors.affiliation: Pain Research Center, School of Medicine, University of Utah, Salt Lake City, Utah, USA.
authors.forename: Perry G
authors.initials: PG
authors.lastname: Fine
authors.forename: David H
authors.initials: DH
authors.lastname: Bradshaw
authors.forename: Mitchell J
authors.initials: MJ
authors.lastname: Cohen
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Connor
authors.forename: Gary
authors.initials: G
authors.lastname: Donaldson
authors.forename: Christopher
authors.initials: C
authors.lastname: Gharibo
authors.forename: Barry E
authors.initials: BE
authors.lastname: Gidal
authors.forename: James Cameron
authors.initials: JC
authors.lastname: Muir
authors.forename: Helen N
authors.initials: HN
authors.lastname: Tselentis
mesh_terms: D004502:Education, Medical, Continuing; D005260:Female; D006801:Humans; D008134:Long-Term Care; D008297:Male; D009735:Nursing Homes; D017063:Outcome Assessment, Health Care; D010146:Pain / Q000534:rehabilitation; D059408:Pain Management
keywords: Geriatrics; Long-Term Care; Pain Management; Performance Improvement