As payment systems move from quantitative to qualitative, and patient perceptions matter almost as much as patient outcomes, pain control lies at the center of our changing healthcare system. Not only are patients asked specifically about how well their pain in controlled in various settings, but research has shown that patients overall satisfaction ratings are influenced directly by how well their pain was managed during hospital stays
So, if pain control is so important, how are things going? Are patients reporting satisfaction with their pain levels?
According to the September 2014 Anesthesiology News article, “Pain Care Improving in Hospitals, but Slowly and Minimally,” pain management is improving but not at the rate most experts would like. A recent study of data collected from more than 1,800 hospitals by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey revealed a statistically significant increase in patient satisfaction with pain care in government-owned, for-profit, and nonprofit hospitals between October 2006 and March 2012. However, as Ajai Raj writes, this increase is smaller than other patient satisfaction measures, including overall care.
“Overall, a majority of patients in the hospital setting are still moderately satisfied with their pain control, but we can certainly do better,” said Anita Gupta, DO, PharmD, principal investigator of the study and vice chair of the Division of Pain Medicine and Regional Anesthesiology at Drexel University College of Medicine, in Philadelphia. She was interviewed for the Anesthesiology News article.
On the other hand, some experts believe the inherently subjective patient satisfaction surveys need to be balanced with other measurable data to get a complete picture of clinical quality. “Some patients will always say that they’re in pain because they want to get a certain feeling. And that’s just the way some patients can be in certain settings,” said John Dombrowski, MD, medical director of the Anesthesiologist Assistant Program and clinical assistant professor at Case Western Reserve University’s campus in Washington, D.C.
“We need to look at other measurements, like their blood pressure and their heart rate,” he told Raj for the Anesthesiology News article. “If their blood pressure and heart rate are normal, they can’t be in much pain because these would be elevated.”
So what should physicians do to balance their patients’ perceptions of pain and very real medical needs? According to Micah Solomon, a customer service, patient satisfaction and patient experience consultant, the first step is to realize that patient satisfaction isn’t the enemy of medical outcomes.
“Done right, the work you do on patient satisfaction, on improving the patient experience, will also contribute to improving your medical outcomes. In the hospital, and upon discharge,” he writes in his recent Forbes article, “9 Patient Experience And Satisfaction Secrets For Hospitals And Healthcare.”
“This should be obvious, but our ingrained conception of win/lose, zero-sum gets in the way of seeing this clearly. A good night’s sleep–nurses coming when you need them without making you suffer in agony–scheduling that is prompt and makes sense–physicians involving the patient and family in treatment and follow-up: of course these contribute to, rather than get in the way of, improved outcomes. It’s (sorry, neurologists) a no-brainer,” Solomon said.
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