Improving Care for the End of Life, Online Edition The Palliative Care Policy Center

Sourcebook : Improving Care for the End of Life : 3.7 Give Patients a Frame of Reference

St. Mary's Medical Center

Patients may not have a frame of reference for their pain and so may find it hard to report or describe it. The team at St. Mary's Medical Center in Madison, Wisconsin, tried several approaches to educate patients about pain management and, at the same time, to heighten provider awareness of the need to ask patients about pain intensity levels. St. Mary's wrote and distributed two patient education pamphlets, developed three algorithms on pain management for health care workers, posted a large 0-to-10 scale in patient rooms, and developed a vital sign sheet with a graph for reported pain intensity and acceptable levels.

The group reviewed five charts and surveyed five patients each week. At the end of a 16-week study, St. Mary's had achieved some of its pain management goals. As documentation improved, so did patient satisfaction.

Table 3.2 Pain Management Goals Met
Week 1Week 8Week 16
Pain level asked65%77%76%
Prompt attention60%100%100%
Acceptable level asked7.2%61%52%
Acceptable level met20% 65%93%
Reprinted with permission of St. Mary's Health Center, St. Louis, MO

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This online version of the book Improving Care for the End of Life: A Sourcebook for Health Care Managers and Clinicians is provided with permission of Americans for Better Care of the Dying [ www.abcd-caring.org ] and Oxford University Press. All rights reserved.

For further information on quality improvement in end-of-life care visit The Palliative Care Policy Center [ www.medicaring.org ].

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