Hospitals can expect to see a new set of pain management measure in early 2003. That's when the Joint Commission on Accreditation of Healthcare Organizations expects to begin field-testing its initial set of standardized pain management performance measures.
"We're not talking about measuring pain, but measuring organizations on how well they manage pain," said Jerod Loeb, vp. for research and performance measurement at JCAHO. "We all think we're doing a good job managing pain, but we don't have any national comparisons or standards. For now, there is no broad agreement on which measures are reliable, valid, and well tested."
Loeb announced the pain management evaluation measures at a national summit on pain management held in San Francisco in early October. A similar session is scheduled for Wash ington, D.C., in early November. "There are numerous measures, but there is a lack of credibility behind many of them," he said. "We absolutely need standardized measures of pain management that transcend the setting, patient mix, and practitioner."
The new measures began as a project of the Performance Measurement Coordinating Council. PMCC is a collaboration formed by JCAHO, the American Medical Association, and the National Committee For Quality Assurance. The three groups each appointed four members to a 12-- member clinical expert panel that will create the pain management measures for JCAHO. Purdue Pharma is providing unrestricted funding to develop what JCAHO is currently calling the "Standardized Performance Measures for Pain Management."
The clinical expert panel was scheduled to complete an initial review of existing pain management measures and indictors by the end of October. Specific recommendations for uniform pain management performance measures will follow later this year or early in 2003. Loeb said JCAHO surveyors could begin using the new performance measures during compliance audits by 2004.
"We don't have any problem evaluating the assessment of pain by an organization, just the management of pain," said Patricia Berry, R.N., assistant professor at the University of Utah College of Nursing. She is also an adviser to the clinical expert panel writing JCAHO's pain performance measures.
The new pain management measures are in addition to existing standards requiring healthcare organizations to evaluate all patients for pain. "There has to be an organizational commitment to managing pain," Berry said. "You look at pain intensely and you do something about it, just as you do something for an adult patient with a temperature of 1040. …