AN INSTITUTIONAL COMMITMENT TO PAIN MANAGEMENT

Purpose: To share the development, implementation, and evaluation of a program called '' An institutional Commitment to pain Management,'' w hich is based on the philosophy of organizational influence on pain ma nagement. Methods: A tested pain education model was disseminated to 3 2 physician/nurse teams in settings throughout California, after which the 64 professionals returned to their institutions to serve as role models and catalysts to change the practice of pain management. Each t eam member completed a 39-item survey about knowledge and attitudes re lated to pain, which was developed by B.R.F. and colleagues, and also identified three goals for the implementation of course information, P recourse data also included administration of the knowledge and attitu des survey to participating physicians' and nurses' colleagues (10 phy sicians and 20 nurses per institution). Each team completed five chart audits using the pain audit tool (PAT), which was developed by B.R,F, and colleagues at the City of Hope National Medical Center, The PAT i dentifies how pain is managed currently at the institutional level, Fi nal course evaluation 8 months after course completion included a summ ary of activities implemented by the teams as well as the factors that served as barriers and benefits to improve the quality of pain manage ment Results: Two hundred seventy-two physicians and 62 nurses complet ed the survey about knowledge and attitudes related to pain, and 154 P ATs were submitted. These results, as well as evaluation at the comple tion of the course, are discussed. Conclusion: The Institutional Commi tment to Pain Management program is an evolving model that wets develo ped to overcome barriers to pain relief by obtaining the commitment fr om institutions to improve the management of pain for their patients. (C) 1995 by American Society of Clinical Oncology.