scholarly journals A Qualitative Study of Hospitalists' Perceptions of Patient Satisfaction Metrics on Pain Management

2017 ◽  
Vol 95 (1) ◽  
pp. 18-26 ◽  
Author(s):  
Susan L. Calcaterra ◽  
Anne D. Drabkin ◽  
Reina Doyle ◽  
Sarah E. Leslie ◽  
Ingrid A. Binswanger ◽  
...  
2020 ◽  
pp. 074391562098472
Author(s):  
Lu Liu ◽  
Dinesh K. Gauri ◽  
Rupinder P. Jindal

Medicare uses a pay-for-performance program to reimburse hospitals. One of the key input measures in the performance formula is patient satisfaction with their hospital care. Physicians and hospitals, however, have raised concerns especially about questions related to patient satisfaction with pain management during hospitalization. They report feeling pressured to prescribe opioids to alleviate pain and boost satisfaction survey scores for higher reimbursements. This over-prescription of opioids has been cited as a cause of current opioid crisis in the US. Due to these concerns, Medicare stopped using pain management questions as inputs in its payment formula. We collected multi-year data from six diverse data sources, employed propensity score matching to obtain comparable groups, and estimated difference-in-difference models to show that, in fact, pain management was the only measure to improve in response to pay-for-performance system. No other input measure showed significant improvement. Thus, removing pain management from the formula may weaken the effectiveness of HVBP program at improving patient satisfaction, which is one of the key goals of the program. We suggest two divergent paths for Medicare to make the program more effective.


2021 ◽  
Author(s):  
Koharu Loulou Chayama ◽  
Jenna Valleriani ◽  
Cara Ng ◽  
Rebecca Haines‐Saah ◽  
Rielle Capler ◽  
...  

2020 ◽  
Vol 2020 ◽  
pp. 1-7 ◽  
Author(s):  
Abigail Kusi Amponsah ◽  
Evans Frimpong Kyei ◽  
John Bright Agyemang ◽  
Hanson Boakye ◽  
Joana Kyei-Dompim ◽  
...  

Staff shortages, deficient knowledge, inappropriate attitudes, demanding workloads, analgesic shortages, and low prioritization of pain management have been identified in earlier studies as the nursing-related barriers to optimal children’s pain management. These studies have mainly been undertaken in developed countries, which have different healthcare dynamics than those in developing countries. The current study, therefore, sought to identify and understand the nursing-related barriers to children’s pain management in the Ghanaian context. A descriptive qualitative study was conducted among 28 purposively sampled nurses working in the pediatric units of five hospitals in the Ashanti region of Ghana. Over the course of three months, participants were interviewed on the barriers which prevented them from optimally managing children’s pain in practice. Recorded interviews were transcribed verbatim and deductively analysed based on a conceptual interest in pain assessment and management-related barriers. NVivo 12 plus software guided data management and analyses. The mean age of participating nurses was 30 years, with majority being females (n = 24). Participants had worked in the nursing profession for an average of five years and in the pediatric care settings for an average of two years. The nursing-related barriers identified in the present study included communication difficulties in assessing and evaluating pain management interventions with children who have nonfunctional speech, insufficient training, misconceptions on the experience of pain in children, lack of assessment tools, and insufficient number of nurses to manage the workload and nurses’ inability to prescribe analgesics. The present study revealed some barriers which prevented Ghanaian nurses from optimally managing children’s pain. Nurses should be educated, empowered, and supported with the requisite material resources to effectively manage children’s pain and improve outcomes for families, healthcare systems, and the nation. Future studies should explore the facilitators and barriers from other stakeholders involved in pediatric pain management.


2014 ◽  
Vol 80 (3) ◽  
pp. 219-228 ◽  
Author(s):  
Girish P. Joshi ◽  
David E. Beck ◽  
Roger Hill Emerson ◽  
Thomas M. Halaszynski ◽  
Jonathan S. Jahr ◽  
...  

Despite advances in pharmacologic options for the management of surgical pain, there appears to have been little or no overall improvement over the last two decades in the level of pain experienced by patients. The importance of adequate and effective surgical pain management, however, is clear, because inadequate pain control 1) has a wide range of undesirable physiologic and immunologic effects; 2) is associated with poor surgical outcomes; 3) has increased probability of readmission; and 4) adversely affects the overall cost of care as well as patient satisfaction. There is a clear unmet need for a national surgical pain management consensus task force to raise awareness and develop best practice guidelines for improving surgical pain management, patient safety, patient satisfaction, rapid postsurgical recovery, and health economic outcomes. To comprehensively address this need, the multidisciplinary Surgical Pain Congress™ has been established. The inaugural meeting of this Congress (March 8 to 10, 2013, Celebration, Florida) evaluated the current surgical pain management paradigm and identified key components of best practices.


2021 ◽  
Author(s):  
Laleh Jalilian ◽  
Irene Wu ◽  
Jakun Ing ◽  
Xuezhi Dong ◽  
George Pan ◽  
...  

BACKGROUND An increasing number of patients require outpatient and interventional pain management. To help meet the rising demand for anesthesia pain subspecialty care in rural and metropolitan areas, healthcare providers have utilized telemedicine for pain management of both interventional and chronic pain patients. OBJECTIVE This study describes telemedicine implementation for pain management at an academic pain division in a large metropolitan area. The study estimates patient cost savings from telemedicine, before and after the California COVID-19 "Safer at Home" directive, and patient satisfaction with telemedicine for pain management care. METHODS This was a retrospective, observational case series study of telemedicine use in a pain division at an urban academic medical center. From August 2019 to June 2020, we evaluated 1,398 patients and conducted 2,948 video visits for remote pain management care. We utilize publicly available IRS Statistics of Income data to estimate hourly earnings by zip code in order to estimate patient cost savings. We estimate median travel time, travel distance, direct cost of travel, and time-based opportunity savings and report patient satisfaction scores. RESULTS Telemedicine patients avoided an estimated median roundtrip driving distance of 26 miles and a median travel time of 69 minutes during afternoon traffic conditions. Within sample, the median hourly earnings was $28/hr. Patients saved a median of $22 on gas and parking and a total of $52 per telemedicine visit based on estimated hourly earnings and travel time. Patients evaluated serially with telemedicine for medication management saved a median of $156 over three visits. 91% of patients surveyed (n = 313) were satisfied with their telemedicine experience. CONCLUSIONS Telemedicine use for pain management reduced travel distance, travel time, and travel and time-based opportunity costs for pain patients. We achieved the successful implementation of telemedicine across a pain division in an urban academic medical center with high patient satisfaction and patient cost savings.


2019 ◽  
Vol 20 (2) ◽  
pp. 133-139
Author(s):  
Anna Peterson ◽  
Marie Berggården ◽  
Anne Söderlund Schaller ◽  
Britt Larsson

2018 ◽  
Vol 32 (10) ◽  
pp. 953-959 ◽  
Author(s):  
Felix Greimel ◽  
Günther Maderbacher ◽  
Clemens Baier ◽  
Timo Schwarz ◽  
Florian Zeman ◽  
...  

AbstractIn the recent past, numerous studies evaluating local infiltration analgesia (LIA) with controversial results have been reported. Efforts have been made to improve patients' outcome regarding operation techniques and material, as well as pain management and anesthetic methods. In this study, postoperative pain management and patient satisfaction were evaluated in patients undergoing total knee replacement surgery with or without intraoperative LIA. Within the context of the “Quality Improvement in Postoperative Pain Management” (QUIPS) project, parameters were collected on the first postoperative day. All patients included in this study underwent primary knee replacement surgery with general anesthesia. Parameters were compared after performing a 1:1 matched-pair analysis within 14 orthopaedic departments. Pain levels and pain management satisfaction were measured using the numerous rating scales, and pain medication use was compared. From 2010 to 2015, 2,789 patients who underwent primary knee arthroplasty with general anesthesia were evaluated within the project, of whom a total of 846 patients could be compared after performing a matched-pair analysis. Pain scores were significantly better in the LIA group (p = 0.019 for activity pain, p = 0.043 for maximum pain, p < 0.001 for minimum pain), but pain management satisfaction was not superior (p = 0.083). Patients with LIA required less opioids in the recovery room (p = 0.048), while nonopioid medication did not differ significantly (p = 0.603). At the ward, 24 hours postoperatively, no significant difference in the use for nonopioids (p = 0.789) could be measured, whereas patients in the LIA group received significantly more opioids (p < 0.001). Although LIA achieved improvement in pain score outcome, and a comparable patient satisfaction level in the immediate postoperative course, the use of LIA in knee arthroplasty, controversially discussed in the current literature, was not able to reduce the need for opioid pain medication in this study.


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