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

Jennifer M Joseph; Davide Gori; Catherine Curtin; Jennifer Hah; Vy Thuy Ho; Steven M Asch; Tina Hernandez-Boussard

doi:10.1016/j.surg.2021.08.004

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.

Authors

Jennifer M Joseph¹, Davide Gori², Catherine Curtin³, Jennifer Hah⁴, Vy Thuy Ho⁵, Steven M Asch⁶, Tina Hernandez-Boussard⁷

Affiliations

¹ Department of Medicine, Stanford University, CA.
² Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy.
³ Department of Surgery, Veterans Affairs Palo Alto Health Care System, CA; Department of Surgery, Stanford University, CA. Electronic address: https://twitter.com/ccurtinprs.
⁴ Division of Pain Medicine, Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University, CA. Electronic address: https://twitter.com/JenniferHahMD.
⁵ Department of Surgery, Stanford University, CA.
⁶ Department of Medicine, Stanford University, CA; Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, CA. Electronic address: https://twitter.com/steveaschmd.
⁷ Department of Medicine, Stanford University, CA; Department of Surgery, Stanford University, CA; Department of Biomedical Data Science, Stanford University, CA. Electronic address: boussard@stanford.edu.

Abstract

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

Abstract

Publication types

MeSH terms

Grants and funding