Rapid detection of pain and its immediate management improves the well-being of patients, reduces the risk of complications and facilitates the return of mobility and independence
Canadian Patient Safety Week is an annual campaign that was started to inspire extraordinary improvement in patient safety and quality. At the McGill University Health Centre (MUHC), we are inspired every day by our colleagues, patients and families. A most notable improvement in patient safety and quality started a year ago this month when Dr. Suzanne Morin and her multidisciplinary team won the 2012 Challenge Q+, an MUHC award created in partnership with the Quebec Blue Cross, that encourages innovative ways to improve the patient experience and optimize quality and clinical effectiveness.
Dr. Morin’s prize money of $150,000 was used to develop the PAINFREE Initiative, a healthcare tool designed to improve pain management of elderly patients, including those with cognitive impairment who present to the Emergency Department (ED) with bone fractures. This target group represents 16 to 21 per cent of patients on any given day at the MUHC adult sites.
“It was important for us to understand the barriers to pain management,” says Dr. Morin, associate professor in the Department of Medicine, Division of General Internal Medecine, “so we conducted a survey of the MUHC Emergency Department staff.” The results revealed different needs for nurses and physicians, which guided the development of educational tools specific to each of these groups.
The PAINFREE Initiative is a multifaceted approach that aims to increase collaboration between physicians, nurses, patients and their families, to improve pain management through rapid documentation of pain and prescription of appropriate analgesia. PowerPoint presentations and point of care tools for health professionals have been developed, as well as fact sheets and a website for patients and their families to better understand and treat pain in the Emergency Department and upon returning home. In order to create a powerful visual identity for the program, a logo, lanyards, pocket cards and posters were designed. The bilingual website, www.painfreeinitiative.org, is set to launch this month.
The PAINFREE initiative is being implemented in the EDs of the MUHC adult sites, starting with the Montreal General (MGH) and the Royal Victoria hospitals (RVH) this autumn. The educational component for nurses began on October 22, followed by a presentation to the physicians on November 11. The program will then be implemented at the Lachine Hospital in January 2014. This staggered launch will allow Dr. Morin and her team to reassess the impact and make any adjustments necessary to the tools and training materials.
“I believe that encouraging better practice in pain management for the elderly will translate into better pain management for all patients,” says Dr. Morin, who actively collaborates with colleagues and other institutions within our network to foster better understanding, knowledge and attitudes towards pain management.
Lisa Rosati-White, a member of the MUHC Patients'/Users' Committee, adds, “It's all about achieving their compliance by examining how we really look at safety for patients, and gearing our messages to them in clear and simple language. Patients need to be engaged and involved in their care from the start. The PAINFREE project approach leads to a faster recovery and return to their regular activities of daily living, improving outcomes, and making it safer and more effective health care. A win-win situation!”