Implementing a pain management service at an Army Medical Center

In 1999, the Joint Commission for Accreditation of Healthcare Organizations published comprehensive pain management standards. Previous research has shown that pain control in people with cancer remains a significant problem in health care, even though cancer pain can be managed effectively in up to 90% of patients. In addition, postoperatively, many patients fail to have adequate pain control because of staff failures to routinely assess pain and pain relief. Many patients, if not questioned, silently tolerate unrelieved pain. National guidelines were published that address both acute and cancer pain in 1992 and 1994, respectively. In 1995, Tripler Army Medical Center dedicated $300,000 to create a 24-hour Pain Management Service to improve pain management. This article describes the structure of, educational programs offered by, and system changes implemented by the Pain Management Service.