Applying quality improvement methods to implement a measurement system for chronic pain-related disability

J Pediatr Psychol. 2010 Jan-Feb;35(1):32-41. doi: 10.1093/jpepsy/jsp001. Epub 2009 Mar 6.

Abstract

Objective: This article describes the application of quality improvement methodology to implement a measurement tool for the assessment of functional status in pediatric patients with chronic pain referred for behavioral intervention.

Methods: The Functional Disability Inventory (FDI), a validated instrument for assessment of pain-related disability, was chosen as the primary clinical outcome measure. Using improvement science methodology, PDSA (Plan-Do-Study-Act) cycles were run to evaluate: (a) regular FDI administration, (b) two administration methods, (c) regular patient feedback, and (d) documentation methods.

Results: Within 1 month, psychologists were administering the FDI at least 80% of the time to patients. A high level of reliability using two administration methods (92.8%) was demonstrated. The FDI was feasible to integrate into clinical practice. Modifications to electronic records further enhanced clinician reliability of documentation.

Conclusions: Quality improvement methods are an innovative way to make process changes in pediatric psychology settings to dependably gather and document evidence-based patient outcomes.

MeSH terms

  • Adolescent
  • Behavior Therapy
  • Child
  • Chronic Disease
  • Evidence-Based Medicine
  • Female
  • Humans
  • Male
  • Pain / diagnosis*
  • Pain Management
  • Pain Measurement / methods*
  • Severity of Illness Index
  • Total Quality Management / methods*