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Updated: Nov 16, 2025
An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP
Published on: January 27, 2010
Towards Better Perioperative Pain Management in Mexico: A Study in a Network of Hospitals Using Quality Improvement
Ana Lilia Garduño-López1, Victor Manuel Acosta Nava1, Lisette Castro Garcés1
1Department of Anesthesiology, Instituto Nacional de Ciencias Médicas y Nutrición "Dr. Salvador Zubirán", Mexico City, Mexico.
Objective:
This was a pre-post study in a network of hospitals in Mexico-City, Mexico. Participants developed and implemented Quality Improvement (QI) interventions addressing perioperative pain management.
Methods:
PAIN OUT, an international QI and research network, provided tools for web-based auditing and feedback of pain management and patient-reported outcomes (PROs) in the clinical routine. Ward- and patient-level factors were evaluated with multi-level models. Change in proportion of patients reporting worst pain ≥6/10 between project phases was the primary outcome.
Results:
Participants created locally adapted resources for teaching and pain management, available to providers in the form of a website and a special issue of a national anesthesia journal. They offered teaching to anesthesiologists, surgeons, including residents, and nurses. Information was offered to patients and families. A total of 2658 patients were audited in 9 hospitals, between July 2016 and December 2018. Participants reported that the project made them aware of the importance of: training in pain management; auditing one's own patients to learn about PROs and that QI requires collaboration between multi-disciplinary teams. Participants reported being unaware that their patients experienced severe pain and lacked information about pain treatment options. Worst pain decreased significantly between the two project phases, as did PROs related to pain interfering with movement, taking a deep breath/coughing or sleep. The opportunity of patients receiving information about their pain treatment options increased from 44% to 77%.
Conclusions:
Patients benefited from improved care and pain-related PROs. Clinicians appreciated gaining increased expertise in perioperative pain management and methods of QI.
Insights
Implementing Quality Improvement (QI) interventions significantly reduced severe pain and improved patient-reported outcomes in Mexico City hospitals. Clinicians gained expertise in pain management and QI methods.
Area of Science:
- Medical Research
- Quality Improvement Science
- Pain Management
Background:
- Perioperative pain management is a critical aspect of patient care.
- Effective pain management strategies are essential for optimal patient recovery and satisfaction.
- Quality Improvement (QI) initiatives can enhance clinical practices and patient outcomes.
Purpose of the Study:
- To assess the impact of QI interventions on perioperative pain management in Mexico City hospitals.
- To evaluate changes in patient-reported outcomes (PROs) related to pain.
- To understand clinicians' perceptions of the QI process and its effect on their expertise.
Main Methods:
- A pre-post study design was employed across a network of hospitals.
- The PAIN OUT network provided tools for web-based auditing and feedback on pain management and PROs.
- Multi-level models were used to evaluate ward- and patient-level factors, with the primary outcome being the change in the proportion of patients reporting worst pain ≥6/10.
Main Results:
- Participants developed and disseminated locally adapted pain management resources and provided multidisciplinary training.
- A total of 2658 patients across 9 hospitals were audited between July 2016 and December 2018.
- Significant reductions in worst pain (≥6/10) and improved PROs were observed. Patient information on pain treatment increased from 44% to 77%.
Conclusions:
- The QI interventions led to improved patient care and pain-related outcomes.
- Clinicians reported enhanced expertise in perioperative pain management and QI methodologies.
- The study highlights the benefits of a systematic approach to improving pain management in clinical settings.
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