Article

Successful organizational improvement processes depend on application of reliable
metrics to establish targets and to monitor progress.
This study examined the
utility of the Pain Care Quality (PCQ) extraction tool in evaluating
implementation of the Stepped Care Model for Pain Management at one Veterans
Health Administration (VHA) healthcare system over 4 yr and in a non-VHA
Federally qualified health center (FQHC) over 2 yr. Two hundred progress notes
per year from VHA and 150 notes per year from FQHC primary care prescribers of
long-term opioid therapy (>90 consecutive days) were randomly sampled. Each note
was coded for the presence or absence of key dimensions of PCQ (i.e., pain
assessment, treatment plans, pain reassessment/outcomes, patient education).
General estimating equations controlling for provider and facility were used to
examine changes in PCQ items over time. Improvements in the VHA were noted in
pain reassessment and patient education, with trends in positive directions for
all dimensions. Results suggest that the PCQ extraction tool is feasible and may
be responsive to efforts to promote organizational improvements in pain care.
Future research is indicated to improve the reliability of the PCQ extraction
tool and enhance its usability.

Langue : ANGLAIS