Tracking Uncontrolled Pain

Presented by: Marie Phillips & Jillian DiClemente | UMH UH Pharmacy Services; HITS MiChart CPOE; HITS Michart Clin Doc


In accordance with the Joint Commission on Accreditation’s objective to improve quality of care standards, which include ensuring pain management and efficacy of treatment of pain in hospitalized patients, Michigan Medicine implemented pain reassessment tasks which are automatically generated after pain medication administration. These tasks have greatly increased compliance in reassessing intensity of pain following pain medication.

Our Pain and Opioid Stewardship initiative was interested in identifying patients with uncontrolled pain. They define uncontrolled pain as two consecutively documented values which are equivalent to 7+ on a 0-10 pain scale. However, identifying consecutive values across multiple possible pain scales proved to be a difficult report to write in the real-time Reporting Workbench platform, due to the platform’s functional limitations.

By leveraging the existing pain documentation, we were able to implement a custom formula driven flowsheet row, which automatically evaluates and files data each time a pain score is documented. This flowsheet row evaluates the current pain score being documented and compares it to the previous documentation, regardless of pain scale used for either. This allows us to track, in real time, if any pain score constitutes consecutive 7+ equivalency pain documentation.

This allows for Pain and Opioid Stewardship to utilize a very straightforward Reporting Workbench report which only has to look for values in the custom formula flowsheet row, rather than trying to evaluate multiple sets of data across multiple rows. This has turned what used to be a process of manual evaluation into something the system automatically calculates.

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