Multidisciplinary approach to improving pain management

On a 30-bed trauma surgical unit in an academic medical center, a best practice group was established. For a first project, we worked on improving the patient's pain experience. The decision was driven by the units Hospital Consumer Assessment of Health Providers and Systems (HCAHPS) pain scores. We had consistently been in the 1st percentile whereas best practice hospital scores were in the 68th percentile for pain. In addition, patients were expressing dissatisfaction with pain care during wound care with physicians. We reviewed the HCAHPS scores and brainstormed possible factors leading to patients' dissatisfaction with their pain care. Staff developed a teaching tool, which included a communication plan for the individual patient's pain plan. Next, we addressed the wound care with the trauma surgeons to develop a better understanding of the problem and identify a solution. The best practice group collaboration meeting became a springboard to address the pain issue for surgical patients through their hospital stays. The nurse manager, educator, pain relief attendant, anesthesia attendant, and 2 trauma surgeons met to discuss how to improve the surgical patient's pain experience. This trauma surgical unit now exceeds the top performers in HCAHPS scores. We have moved from the 1st percentile to the 90th percentile in 5 months.