Pain management: screening and assessment of pain as part of a comprehensive case management process.
OBJECTIVE
Pain management, episodic and chronic, is a major issue in health care today, affecting more than 76 million people across care-delivery settings from acute care to rehabilitation, workers' compensation to primary care. As a result, professional case managers occupy an important role within an interdisciplinary care team to address pain as part of a comprehensive case management process, from intake and assessment through care delivery and transitions of care.


METHODS
Pain management, as part of the comprehensive case management process, is applicable across the case management spectrum, including hospitals, accountable care organizations, patient-centered medical homes, physician practices, clinics, occupational health clinics, workers' compensation, and other settings in which case managers work with clients and their support systems.


CONCLUSIONS
The prevalence of pain across the care continuum, affecting individuals at various stages of an individual's lifecycle, raises the importance of acute and chronic pain assessments as part of the overall case assessment. In addition to screening for pain, case management assessments must look for signs of depression, as well as the potential for abuse/misuse of opioid medications, which is an alarming public health threat. Given their clinical expertise, their roles as advocates, their ability to conduct a comprehensive client/patient assessment, and their expertise in using tools such as motivational interviewing, professional case managers-and particularly those who are board certified-occupy a central role in pain management as part of a patient-centered approach.


CONCLUSIONS
Case managers must understand the impact of both pain and pain medications on the client's daily functions, from a health and safety perspective. Pain management should be examined through the lens of professional case management, and what a competent case manager can do to advocate for clients who are experiencing pain, whether acute or chronic, while facilitating the sharing of information among various members of an interdisciplinary care team and coordinating care.
Jolynne "Jo" Carter, RN, BSN, CCM, is Chair-Elect of the Commission for Case Manager Certification (CCMC), and also Associate Vice President of Network Services for Paradigm Management Services LLC, responsible for the management of national networks of workers' compensation catastrophic nurse case managers and physicians. Annette C. Watson, RN-BC, CCM, MBA, is a Past-Chair of the CCMC, and President of Watson International Consulting, LLC, a privately held consulting firm specializing in the effective design and implementation of strategies that result in health and human services organizational performance improvements. Patrice V. Sminkey, RN, is CEO of the CCMC, which is the first and largest nationally accredited organization that certifies case managers. To date, more than 35,000 professional case managers have been board-certified as Certified Case Managers. For more information, see the Commission website at www.ccmcertification.org.
Jolynne Jo
JJ
Carter
Annette C
AC
Watson
Patrice V
PV
Sminkey
D000328:Adult; D003191:Comprehensive Health Care / Q000458:organization & administration*; D004496:Education, Continuing; D005260:Female; D006801:Humans; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement / Q000379:methods*; D018802:Patient-Centered Care