Organization of hospital-based acute pain management programs

Background. The management of acute pain is an aspect of hospital-based pra ctice that has been neglected. Control of pain is important for ethical rea sons, for compliance with new guidelines and standards, and for optimizing patient satisfaction and outcomes. Methods. We review the rationale for establishing priority to the control o f acute pain, the importance of an institutional approach to improve pain m anagement, and specific steps in the establishment and conduct of an acute pain program. Results. Improvement in pain control depends on an institutional approach t o facilitate changes in attitude and prioritization. Pain management progra ms should provide for patient and staff education, adequate documentation o f care, institutional standards for pain control, quality assurance/continu ous quality improvement (CQI) activities, and periodic review of practice a nd policy. Conclusions, Effective pain management can set the stage for a rehabilitati on approach to postoperative care, which should lead to earlier recovery an d improved outcomes.