Nursing homes register 41 percent drop in residents' pain

PROVIDENCE, R.I. -- Relieving pain in nursing home residents doesn't require additional staff or a lot of money. What it takes: A multifaceted improvement process that stresses education, collaboration, mentoring and most importantly rapid changes in pain assessment and treatment.

Researchers at Brown Medical School and health care experts at Quality Partners of Rhode Island came to this conclusion after conducting an innovative study in 17 Rhode Island nursing homes. The team focused on a critical issue in elder care: how to treat pain.

Previous research has shown that four in 10 nursing home residents have persistent, severe pain. Yet several studies have found that complaints of pain often go unrecognized and that residents are inadequately treated or not treated at all.

To address the problem, researchers at Brown Medical School teamed with Quality Partners of Rhode Island to test rapid-cycle quality improvement. Under that model, organizations set a clear performance goal, come up with tools to measure success, then make changes to hit their target. These changes are made and their success measured quickly. The "plan-do-study-act" process is ongoing, with refinements in practice made along the way. Researchers modified the model to include mentoring and information sharing.

Rapid-cycle quality improvement has been used to improve hospital care for nearly a decade. Last year, Brown Medical School researchers published results of the first test of the process in nursing homes in the nation, showing that it resulted in significant improvements in the prevention and treatment of bed sores. Now, the Brown and Quality Partners team is the first to apply the process to pain management.

The process produced some dramatic results in nursing homes in the study:

  • the use of appropriate pain assessments, which gauge factors such as intensity of discomfort and response to treatment, rose f

  • Contact: Wendy Lawton
    Brown University

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