Harmony Healthcare Blog

Exploring Pain Management Goals in the SNF with Advancing Excellence

Posted by Kris Mastrangelo, OTR/L, LNHA, MBA on Fri, Sep 25, 2015

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Edited by Kris Mastrangelo

painMany Skilled Nursing Facilities become concerned when they note that their long and short stay Quality Measures for patients who self-report Moderate to Severe Pain is elevated above facility benchmarks or national averages.  This concern is justified and opens an excellent opportunity to investigate current facility practices for pain control.  In order to improve the quality of care and quality of life of residents, it is important that SNFs establish and promote Pain Management Goals within their facility.


What is Pain Management?

The Advancing Excellence in America’s Nursing Homes Campaign states, “Pain management means that nursing homes will implement a comprehensive system to address issues related to pain. This system involves assessing and managing pain in residents, both long and short term, so that all residents have individualized, person-centered care plans. Nursing home residents will receive appropriate care to prevent and minimize episodes of moderate to severe pain. Less than adequate pain management can affect residents’ daily activities and quality of life. It can also cause depression, sleeplessness, restlessness, or decline in appetite and unintentional weight loss.”

How Does Pain Management Benefit Residents?

  • Residents can express their wishes for pain management.
  • Residents do not experience a decline in functional status due to uncontrolled pain.
  • Residents are not at risk for depression due to uncontrolled pain.
  • Residents do not experience a decline in quality of life due to unmanaged pain.

How Does Pain Management Benefit Nursing Home Staff?

  • Staff members are more likely to experience enhanced job satisfaction
  • Staff will have tools and resources to address the various aspects of pain management to enhance quality of care.

How Does Pain Management Benefit Nursing Homes?

  • Nursing homes have satisfied residents and families, which translates into better care and image in the community.
  • Nursing homes have improved quality measures due to improved resident care and satisfaction results.   

Achieving Pain Management Goals

The key to achieving Pain Management Goals is to identify and establish baselines within your SNF.  This can be achieved by documenting your work and monitoring outcomes and the processes related to your outcomes. Advancing Excellence recommends that you collect data for several months to establish a solid baseline and set a target for your improvement; then continue collecting data.  To ensure proper documentation, providers should be familiar with the MDS 3.0 Quality Measure User’s Manual, which can be found at this web address: 

http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/NHQIQualityMeasures.html

Providers who wish to investigate potential causes for a higher result for these Quality Measures should first consider interviewing techniques and practices.  Consistent interviewing techniques and practices, as outlined in the RAI User’s Manual, are critical in assuring that patients are not unnecessarily “screened out” of the resident interview process. 

Facilities should also examine their current pain control practices.  This process would make an excellent Continuous Quality Improvement (CQI) project or Performance Improvement Project (PIP) for the Quality Assurance team.  Outcomes of the CQI/PIP could include patient reports of overall satisfaction with their stay and positive perception of their SNF/LTC experience.  Facilities should also be aware that Quality Measure reports are “old” data.  Proactive management of pain control issues is the best way to ensure patients have a positive and pain-free stay.

To learn more about Advancing Excellence’s Pain Goal, visit their website:  https://www.nhqualitycampaign.org/goalDetail.aspx?g=pain

Still have questions, please contact Harmony Healthcare by clicking here or calling our office at (800) 530-4413.


 

Tags: Pain Management, advancing excellence

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