Evaluation of the performance improvement CME paradigm for pain management in the long-term care setting

Pain Med. 2014 Mar;15(3):403-9. doi: 10.1111/pme.12339. Epub 2014 Jan 14.

Abstract

Objective: A performance improvement continuing medical education (PI CME) activity was designed to assist clinicians with accurately identifying and appropriately managing persistent pain in long-term care facility (LTCF) residents.

Design: Volunteer LTCFs participated in a three-stage PI CME model consisting of: 1) baseline assessment, 2) implementation of practice improvement interventions, and 3) reassessment. Expert faculty chose performance measures and interventions for the activity. A champion was designated ateach LTCF to collect resident charts and enter data into an online database.

Setting: Eight LTCFs located across the United States participated in the activity.

Patients: Fifty resident charts were randomly selected by each LTCF champion (25 for stage 1 and 25 for stage 3); a total of 350 charts were reviewed.

Interventions: In addition to a toolkit containing numerous performance improvement resources, an in-service meeting led by an expert faculty member was conducted at each LTCF.

Outcome measures: Stage 3 data were collected 6 weeks after implementation of interventions and compared with stage 1 baseline data to measure change in performance.

Results: Aggregate data collected from seven LTCFs completing the PI CME activity through stage 3 revealed improvements from baseline in four of five performance measures.

Conclusions: This CME activity allowed for collection of data demonstrating performance improvement in persistent pain management. The tools used as part of the intervention (available at http://www.achlpicme.org/LTC/toolkit) may help other clinicians enhance their management of LTCF residents with persistent pain.

Keywords: Geriatrics; Long-Term Care; Pain Management; Performance Improvement.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Education, Medical, Continuing*
  • Female
  • Humans
  • Long-Term Care
  • Male
  • Nursing Homes*
  • Outcome Assessment, Health Care
  • Pain / rehabilitation
  • Pain Management*