Gaps in standardized postoperative pain management quality measures: A systematic review

Surgery. 2022 Feb;171(2):453-458. doi: 10.1016/j.surg.2021.08.004. Epub 2021 Sep 15.


Background: The goal of this study was an assessment of availability postoperative pain management quality measures and National Quality Forum-endorsed measures. Postoperative pain is an important clinical timepoint because poor pain control can lead to patient suffering, chronic opiate use, and/or chronic pain. Quality measures can guide best practices, but it is unclear whether there are measures for managing pain after surgery.

Methods: The National Quality Forum Quality Positioning System, Agency for Healthcare Research and Quality Indicators, and Centers for Medicare and Medicaid Services Measures Inventory Tool databases were searched in November 2019. We conducted a systematic literature review to further identify quality measures in research publications, clinical practice guidelines, and gray literature for the period between March 11, 2015 and March 11, 2020.

Results: Our systematic review yielded 1,328 publications, of which 206 were pertinent. Nineteen pain management quality measures were identified from the quality measure databases, and 5 were endorsed by National Quality Forum. The National Quality Forum measures were not specific to postoperative pain management. Three of the non-endorsed measures were specific to postoperative pain.

Conclusion: The dearth of published postoperative pain management quality measures, especially National Quality Forum-endorsed measures, highlights the need for more rigorous evidence and widely endorsed postoperative pain quality measures to guide best practices.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.
  • Systematic Review

MeSH terms

  • Centers for Medicare and Medicaid Services, U.S. / statistics & numerical data
  • Databases, Factual / statistics & numerical data
  • Humans
  • Medicare / statistics & numerical data
  • Pain Management / standards
  • Pain Management / statistics & numerical data*
  • Pain, Postoperative / therapy*
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians' / organization & administration
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Professional Practice Gaps / statistics & numerical data*
  • United States
  • United States Agency for Healthcare Research and Quality / statistics & numerical data