- Email: [email protected]
Does assessment of patient satisfaction with pain care lead to patient harm?
Healthcare 4 (2016) 6–8
Contents lists available at ScienceDirect
Healthcare journal homepage: www.elsevier.com/locate/hjdsi
The Leading Edge
Does assessment of patient satisfaction with pain care lead to patient harm? Michael A. Ashburn n, Lee A. Fleisher Department of Anesthesiology and Critical Care, University of Pennsylvania, USA
art ic l e i nf o Article history: Received 14 April 2015 Received in revised form 19 June 2015 Accepted 4 August 2015 Available online 29 January 2016 Keywords: Patient satisfaction Patient outcomes Pain care in the hospital setting Opioid-induced adverse events
As part of the value proposition in healthcare, there is growing interest in patient reported outcomes (PRO) and their measurement (PROMs). Within that paradigm, there is interest in improving patient satisfaction with health care. This is due in no small part to the value-based purchasing initiatives by the Centers for Medicare and Medicaid Services (CMS), which links patient satisfaction to payment for health care services.1 However, questions abound with regard to the appropriateness of such a link, especially with regard to patient satisfaction with pain care.2 Indeed, concern has been raised that linking payment to patient satisfaction with pain care may lead to an increase in the use of opioids, increasing the risk of patient harm, and thus worsening patient outcomes. In this perspective, we will outline an approach to improving satisfaction with pain management in the hospital setting while minimizing potential harm from the current focus on performance measures. Senators Chuck Grassley and Diane Feinstein expressed concern over the collection of patient satisfaction data, stating “We write to express concerns with the effect of the use of patient satisfaction surveys by the Centers for Medicare and Medicaid Services (CMS) on the growing epidemic of abuse of prescription opioid pain relievers (OPRs).” The letter, sent to CMS Administrator Marilyn Travenner on June 23, 2014,1 cited 2 articles in the press n Correspondence to: Penn Pain Medicine Center, 1840 South Street, Philadelphia, PA 19035, USA. E-mail address: [email protected] (M.A. Ashburn). 1 Letter available at http://www.grassley.senate.gov/sites/default/files/news/ upload/Letter%20to%20CMS%20%28Patient%20Surveys%29%206-23-14.pdf (accessed 31 December 2014).
http://dx.doi.org/10.1016/j.hjdsi.2015.08.001 2213-0764/& 2015 Elsevier Inc. All rights reserved.
that claimed that physician prescribing in the hospital outpatient setting led to excessive prescribing of opioids. Other authors have expressed concern that efforts to improve pain care in the outpatient setting3,4 as well as the hospital setting2 have increased the prescribing of opioids, which led to significant increases in the incidence of opioid-related serious adverse events. Indeed, there is evidence that the routine use of the numeric pain rating scale to obtain patient-reported pain intensity to guide decision making regarding the administration of opioids is associated with increased use of opioids with the potential for increased harm.5 Likewise, the incidence of opioid-induced adverse events (i.e. unrecognized respiratory depression or respiratory arrest) has been reported to have increased from 11 per 100,000 inpatient days to 25 per 100,000 inpatient days following the implementation of the Joint Commission on Accreditation of Healthcare Organizations (Joint Commission) pain standards and increased the use of opioids.6 It is important to note that opioidrelated adverse events also increase total hospital costs and length of stay.7 Both CMS and the Joint Commission collect data regarding patient satisfaction through the use of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey.8 There is an important reason that patients' pain experience during hospitalization is a prominent part of the HCAPHS survey. Hospitalized patients often report poorly controlled pain, including those patients on nonsurgical units. Pain is common following surgery and trauma, and when proper pain therapy is integrated into a standardized process of perioperative care, surgical patients can benefit from early mobilization, decreased
M.A. Ashburn, L.A. Fleisher / Healthcare 4 (2016) 6–8
incidence of respiratory-related complications, and earlier hospital discharge.9,10 Pain is also a common problem for medical inpatients, occurring in almost half of all medical inpatients, and can impede patient mobilization and hospital discharge.11 Unfortunately, there is limited evidence to guide physician decision making regarding optimal pain management in the nonsurgical medical inpatient population.12 Part of the potential unintended consequences of utilizing the HCAHPS survey to collect patient input and drive treatment regarding pain care relates to how it is measured. Pain is assessed using 2 questions: “how often was your pain well controlled”, and “how often did the hospital staff do everything they could to help you with your pain.” The results of the survey are often reported as an adjusted proportion of top category (“top-box”) responses. For example, the response “always”, rather than “usually”, “sometimes”, or “never” is considered a positive response. Focusing on a goal of “always” with respect to achieving pain control may therefore drive overaggressive treatment with unintended patient harm. Providers often rely on the administration of opioids to treat pain in the inpatient setting. However, recent data suggest that providers often lack basic knowledge regarding the proper patient assessment as well as proper use of opioids,13 including the identification of patients who may be at high risk for opioid-induced adverse events.14,15 Indeed, the Joint Commission released a Sentinel Alert entitled “Safe use of Opioids in Hospitals” that recommended improved patient assessment and management to lower the incidence of opioid overdose in the inpatient setting.16 This may include continuous pulse oximetry or capnography, neither of which is routinely performed. The current HCAPHS metric may be influenced by factors other than inadequate pain medications and aggressive treatment with opioids may drive management in unintended ways. Considerable work has been done to understand what factors are associated with high levels of patient satisfaction with pain care in a variety of inpatient patient populations.17 Patient demographics and preexisting conditions appear to significantly impact patient satisfaction. For example, patients receiving chronic opioids or benzodiazepines appear to report low satisfaction.18 Women, patients who reported being in poor health, and patients who reported depression were also more likely to be unsatisfied with pain relief.19 Likewise, other investigators reported that patients with limitations to activities of daily living, a high number of comorbid conditions, depression, anxiety, and poor quality of life report an increased pain burden during hospitalization.20 Those patients reporting high levels of pain, anxiety, depression also reported lower levels of satisfaction with pain treatment. While patient-reported pain is indeed associated with patient satisfaction with pain care in many patients,21 these other factors can have significant impact on patient satisfaction. Interestingly, patients can report satisfaction with pain care even when also reporting moderate to severe pain. Patient satisfaction does not appear to be associated with the type of anesthesia or pain therapy offered. Rather, satisfaction is more strongly associated with patient impressions of improvement in pain control, and their impressions regarding the appropriateness of the care they received. Patient expectations, involvement in decision-making, and maintenance of control appear to be very important contributors to satisfaction with pain care.22 Pain relief was more common in patients who received information regarding pain and its treatment, who received regular pain assessment, who had modifications made to pain treatment when necessary, and who did not wait long periods of time to receive requested pain medication.19 Improving pain care requires an interdisciplinary approach that includes education on proper patient assessment (including the development of new PROMs) and treatment using appropriate
7
multi-modal therapy.23 For example, it has been suggested that early patient assessment to identify patients at high risk for poor pain control may allow for early patient education and intervention, improving both pain control and patient satisfaction with pain care.24 Indeed, such efforts appear to improve measures of quality related to pain care, as well as measures of patient satisfaction with pain care. Outcomes may be optimized when pain specialty care is available. Improving patient satisfaction with pain care is not easy. Efforts focused only on the use of opioids are misguided, and if increased opioid use is advocated, the efforts may lead to increased risk of patient harm. However, integrated, interdisciplinary efforts to properly assess and treat pain and other symptoms likely will improve pain control, lower risk of harm, and improve patient satisfaction. Anesthesiologists have traditionally played a leadership role within the surgical and trauma care teams, including the development and implementation of pain specialty care for the hospitalized patient.25,26 An interdisciplinary pain treatment team approach that includes pain specialists can be successful in developing and implementing solutions for pain care throughout the hospital. There is growing interest in compensating physicians and others for providing high quality care, rather than only on volume of care. Such efforts are laudable, but care must be taken to properly select performance measures, and actively adjust the selected measures as experience is gained regarding their impact on physician performance. The need to engage in active learning and make changes as new information is gained should not be unexpected, and certainly does not mean that efforts to properly align physician payment with quality care is fundamentally flawed. Senators Feinstein and Grassley are correct in their belief that prescription drug abuse (i.e., chronic outpatient pain management) is a public health epidemic in the United States. In addition, we agree that there is some evidence to support the belief that good-faith efforts to improve pain care in the inpatient setting has led to increased use of opioids and thus an increase in the incidence of opioid-related serious adverse events. However, the problem does not lie in the decision to assess patient satisfaction with pain care. Rather, the challenge – and opportunity – is to properly use the information provided through HCAHPS and other outcome data sources to guide efforts to improve pain care to the people we care for.
References 1. Centers for Medicare and Medicaid Services, HHS. Medicare program; hospital inpatient prospective payment systems for acute care hospitals and the longterm care hospital prospective payment system and fiscal year 2015 rates; quality reporting requirements for specific providers; reasonable compensation equivalents for physician services in excluded hospitals and certain teaching hospitals; provider administrative appeals and judicial review; enforcement provisions for organ transplant centers; and electronic health record (EHR) incentive program. Final rule. Federal Register. 2014;79: 49853-50536. 2. P.F. White, H. Kehlet, Improving pain management: are we jumping from the frying pan into the fire? Anesth. Analg. 105 (2007) 10–12. 3. A. Lembke, Why doctors prescribe opioids to known opioid abusers, N. Engl. J. Med. 367 (2012) 1580–1581. 4. A. Zgierska, M. Miller, D. Rabago, Patient satisfaction, prescription drug abuse, and potential unintended consequences, JAMA 307 (2012) 1377–1378. 5. P.E. Frasco, J. Sprung, T.L. Trentman, The impact of the joint commission for accreditation of healthcare organizations pain initiative on perioperative opiate consumption and recovery room length of stay, Anesth. Analg. 100 (2005) 162–168. 6. H. Vila Jr., R.A. Smith, M.J. Augustyniak, et al., The efficacy and safety of pain management before and after implementation of hospital-wide pain management standards: is patient safety compromised by treatment based solely on numerical pain ratings? Anesth. Analg. 101 (2005) 474–480. 7. G.M. Oderda, R.S. Evans, J. Lloyd, et al., Cost of opioid-related adverse drug events in surgical patients, J. Pain Symptom Manag. 25 (2003) 276–283. 8. L.A. Giordano, M.N. Elliott, E. Goldstein, W.G. Lehrman, P.A. Spencer, Development, implementation, and public reporting of the HCAHPS survey, Med. Care Res. Rev. 67 (2010) 27–37.
8
M.A. Ashburn, L.A. Fleisher / Healthcare 4 (2016) 6–8
9. Pamela E Macintyre, S Schug, D Scott, E Visser, S Walker (Eds.), Acute Pain Management: Scientific Evidence, Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine, Melborne, 2010, Third edition. 10. American Society of Anesthesiologists Task Force on Acute Pain Management, Practice guidelines for acute pain management in the perioperative setting: an updated report by the American Society of Anesthesiologists Task Force on Acute Pain Management, Anesthesiology 116 (2012) 248–273. 11. K. Kroenke, T. Stump, D.O. Clark, C.M. Callahan, C.J. McDonald, Symptoms in hospitalized patients: outcome and satisfaction with care, Am. J. Med. 107 (1999) 425–431. 12. M. Helfand, M. Freeman, Assessment and management of acute pain in adult medical inpatients: a systematic review, Pain Med. 10 (2009) 1183–1199. 13. M. Gonzalez-Fernandez, H. Aboumatar, D. Conti, A.M. Patel, M.A. Purvin, M. Hanna, Educational gaps among healthcare providers: an institution needs assessment to improve pain management for postsurgical patients, J. Opioid Manag. 10 (2014) 345–351. 14. Pennsylvania Patient Safety Authority, Adverse drug events with HYDROmorphone: How preventable are they? Pa. Patient Saf. Advis. 7 (2010) 69–75. 15. M.C. Gaunt, D. Alghandi, M. Grissinger, Results of the 2013-2014 opioid knowledgeassessment: progress seen, but room for improvement, Pa. Patient Saf. Advis. 11 (2014) 124–130. 16. The Joint Commission. Safe use of opioids in hospitals. Sentinel Event Alert: The Joint Commission; 2012. 17. M. Schwenkglenks, H.J. Gerbershagen, R.S. Taylor, et al., Correlates of satisfaction with pain treatment in the acute postoperative period: results from the international PAIN OUT registry, Pain 155 (2014) 1401–1411. 18. DP Mather, W Wong, P Woo, et al., Perioperative factors associated with HCAHPS responses of 2,758 surgical patients, Pain Med. (2014). 19. P.A. Bovier, A. Charvet, A. Cleopas, N. Vogt, T.V. Perneger, Self-reported management of pain in hospitalized patients: link between process and outcome, Am. J. Med. 117 (2004) 569–574. 20. N.A. Desbiens, A.W. Wu, S.K. Broste, et al., Pain and satisfaction with pain control in seriously ill hospitalized adults: findings from the SUPPORT research investigations. For the SUPPORT investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment, Crit. Care Med. 24 (1996) 1953–1961. 21. C.T. Whelan, L. Jin, D. Meltzer, Pain and satisfaction with pain control in hospitalized medical patients: no such thing as low risk, Arch. Intern. Med. 164 (2004) 175–180.
22. R.M. Andrews, A.L. Browne, F. Wood, S.A. Schug, Predictors of patient satisfaction with pain management and improvement 3 months after burn injury, J. Burn Care Res. 33 (2012) 442–452. 23. G. Haller, T. Agoritsas, C. Luthy, V. Piguet, A.C. Griesser, T. Perneger, Collaborative quality improvement to manage pain in acute care hospitals, Pain Med. 12 (2011) 138–147. 24. K.R. Archer, R.C. Castillo, S.T. Wegener, C.M. Abraham, W.T. Obremskey, Pain and satisfaction in hospitalized trauma patients: the importance of self-efficacy and psychological distress, J. Trauma Acute Care Surg. 72 (2012) 1068–1077. 25. L.B. Ready, Acute pain: lessons learned from 25,000 patients, Reg. Anesth. Pain Med. 24 (1999) 499–505. 26. L.B. Ready, R. Oden, H.S. Chadwick, et al., Development of an anesthesiologybased postoperative pain management service, Anesthesiology 68 (1988) 100–106.
Conflict of interest disclosure statement This statement accompanies the article "Does assessment of patient satisfaction with pain care lead to patient harm?" authored by Michael A. Ashburn and co-authored by Lee A. Fleisher and submitted to Healthcare as an original article. Below all authors have disclosed relevant commercial associations that might pose a conflict of interest: Consultant arrangements: None. Stock/other equity ownership: None. Patent licensing arrangements: None. Grants/research support: None. Employment: None. Speakers' bureau: None. Expert witness: None. Other: None.
Contents lists available at ScienceDirect
Healthcare journal homepage: www.elsevier.com/locate/hjdsi
The Leading Edge
Does assessment of patient satisfaction with pain care lead to patient harm? Michael A. Ashburn n, Lee A. Fleisher Department of Anesthesiology and Critical Care, University of Pennsylvania, USA
art ic l e i nf o Article history: Received 14 April 2015 Received in revised form 19 June 2015 Accepted 4 August 2015 Available online 29 January 2016 Keywords: Patient satisfaction Patient outcomes Pain care in the hospital setting Opioid-induced adverse events
As part of the value proposition in healthcare, there is growing interest in patient reported outcomes (PRO) and their measurement (PROMs). Within that paradigm, there is interest in improving patient satisfaction with health care. This is due in no small part to the value-based purchasing initiatives by the Centers for Medicare and Medicaid Services (CMS), which links patient satisfaction to payment for health care services.1 However, questions abound with regard to the appropriateness of such a link, especially with regard to patient satisfaction with pain care.2 Indeed, concern has been raised that linking payment to patient satisfaction with pain care may lead to an increase in the use of opioids, increasing the risk of patient harm, and thus worsening patient outcomes. In this perspective, we will outline an approach to improving satisfaction with pain management in the hospital setting while minimizing potential harm from the current focus on performance measures. Senators Chuck Grassley and Diane Feinstein expressed concern over the collection of patient satisfaction data, stating “We write to express concerns with the effect of the use of patient satisfaction surveys by the Centers for Medicare and Medicaid Services (CMS) on the growing epidemic of abuse of prescription opioid pain relievers (OPRs).” The letter, sent to CMS Administrator Marilyn Travenner on June 23, 2014,1 cited 2 articles in the press n Correspondence to: Penn Pain Medicine Center, 1840 South Street, Philadelphia, PA 19035, USA. E-mail address: [email protected] (M.A. Ashburn). 1 Letter available at http://www.grassley.senate.gov/sites/default/files/news/ upload/Letter%20to%20CMS%20%28Patient%20Surveys%29%206-23-14.pdf (accessed 31 December 2014).
http://dx.doi.org/10.1016/j.hjdsi.2015.08.001 2213-0764/& 2015 Elsevier Inc. All rights reserved.
that claimed that physician prescribing in the hospital outpatient setting led to excessive prescribing of opioids. Other authors have expressed concern that efforts to improve pain care in the outpatient setting3,4 as well as the hospital setting2 have increased the prescribing of opioids, which led to significant increases in the incidence of opioid-related serious adverse events. Indeed, there is evidence that the routine use of the numeric pain rating scale to obtain patient-reported pain intensity to guide decision making regarding the administration of opioids is associated with increased use of opioids with the potential for increased harm.5 Likewise, the incidence of opioid-induced adverse events (i.e. unrecognized respiratory depression or respiratory arrest) has been reported to have increased from 11 per 100,000 inpatient days to 25 per 100,000 inpatient days following the implementation of the Joint Commission on Accreditation of Healthcare Organizations (Joint Commission) pain standards and increased the use of opioids.6 It is important to note that opioidrelated adverse events also increase total hospital costs and length of stay.7 Both CMS and the Joint Commission collect data regarding patient satisfaction through the use of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey.8 There is an important reason that patients' pain experience during hospitalization is a prominent part of the HCAPHS survey. Hospitalized patients often report poorly controlled pain, including those patients on nonsurgical units. Pain is common following surgery and trauma, and when proper pain therapy is integrated into a standardized process of perioperative care, surgical patients can benefit from early mobilization, decreased
M.A. Ashburn, L.A. Fleisher / Healthcare 4 (2016) 6–8
incidence of respiratory-related complications, and earlier hospital discharge.9,10 Pain is also a common problem for medical inpatients, occurring in almost half of all medical inpatients, and can impede patient mobilization and hospital discharge.11 Unfortunately, there is limited evidence to guide physician decision making regarding optimal pain management in the nonsurgical medical inpatient population.12 Part of the potential unintended consequences of utilizing the HCAHPS survey to collect patient input and drive treatment regarding pain care relates to how it is measured. Pain is assessed using 2 questions: “how often was your pain well controlled”, and “how often did the hospital staff do everything they could to help you with your pain.” The results of the survey are often reported as an adjusted proportion of top category (“top-box”) responses. For example, the response “always”, rather than “usually”, “sometimes”, or “never” is considered a positive response. Focusing on a goal of “always” with respect to achieving pain control may therefore drive overaggressive treatment with unintended patient harm. Providers often rely on the administration of opioids to treat pain in the inpatient setting. However, recent data suggest that providers often lack basic knowledge regarding the proper patient assessment as well as proper use of opioids,13 including the identification of patients who may be at high risk for opioid-induced adverse events.14,15 Indeed, the Joint Commission released a Sentinel Alert entitled “Safe use of Opioids in Hospitals” that recommended improved patient assessment and management to lower the incidence of opioid overdose in the inpatient setting.16 This may include continuous pulse oximetry or capnography, neither of which is routinely performed. The current HCAPHS metric may be influenced by factors other than inadequate pain medications and aggressive treatment with opioids may drive management in unintended ways. Considerable work has been done to understand what factors are associated with high levels of patient satisfaction with pain care in a variety of inpatient patient populations.17 Patient demographics and preexisting conditions appear to significantly impact patient satisfaction. For example, patients receiving chronic opioids or benzodiazepines appear to report low satisfaction.18 Women, patients who reported being in poor health, and patients who reported depression were also more likely to be unsatisfied with pain relief.19 Likewise, other investigators reported that patients with limitations to activities of daily living, a high number of comorbid conditions, depression, anxiety, and poor quality of life report an increased pain burden during hospitalization.20 Those patients reporting high levels of pain, anxiety, depression also reported lower levels of satisfaction with pain treatment. While patient-reported pain is indeed associated with patient satisfaction with pain care in many patients,21 these other factors can have significant impact on patient satisfaction. Interestingly, patients can report satisfaction with pain care even when also reporting moderate to severe pain. Patient satisfaction does not appear to be associated with the type of anesthesia or pain therapy offered. Rather, satisfaction is more strongly associated with patient impressions of improvement in pain control, and their impressions regarding the appropriateness of the care they received. Patient expectations, involvement in decision-making, and maintenance of control appear to be very important contributors to satisfaction with pain care.22 Pain relief was more common in patients who received information regarding pain and its treatment, who received regular pain assessment, who had modifications made to pain treatment when necessary, and who did not wait long periods of time to receive requested pain medication.19 Improving pain care requires an interdisciplinary approach that includes education on proper patient assessment (including the development of new PROMs) and treatment using appropriate
7
multi-modal therapy.23 For example, it has been suggested that early patient assessment to identify patients at high risk for poor pain control may allow for early patient education and intervention, improving both pain control and patient satisfaction with pain care.24 Indeed, such efforts appear to improve measures of quality related to pain care, as well as measures of patient satisfaction with pain care. Outcomes may be optimized when pain specialty care is available. Improving patient satisfaction with pain care is not easy. Efforts focused only on the use of opioids are misguided, and if increased opioid use is advocated, the efforts may lead to increased risk of patient harm. However, integrated, interdisciplinary efforts to properly assess and treat pain and other symptoms likely will improve pain control, lower risk of harm, and improve patient satisfaction. Anesthesiologists have traditionally played a leadership role within the surgical and trauma care teams, including the development and implementation of pain specialty care for the hospitalized patient.25,26 An interdisciplinary pain treatment team approach that includes pain specialists can be successful in developing and implementing solutions for pain care throughout the hospital. There is growing interest in compensating physicians and others for providing high quality care, rather than only on volume of care. Such efforts are laudable, but care must be taken to properly select performance measures, and actively adjust the selected measures as experience is gained regarding their impact on physician performance. The need to engage in active learning and make changes as new information is gained should not be unexpected, and certainly does not mean that efforts to properly align physician payment with quality care is fundamentally flawed. Senators Feinstein and Grassley are correct in their belief that prescription drug abuse (i.e., chronic outpatient pain management) is a public health epidemic in the United States. In addition, we agree that there is some evidence to support the belief that good-faith efforts to improve pain care in the inpatient setting has led to increased use of opioids and thus an increase in the incidence of opioid-related serious adverse events. However, the problem does not lie in the decision to assess patient satisfaction with pain care. Rather, the challenge – and opportunity – is to properly use the information provided through HCAHPS and other outcome data sources to guide efforts to improve pain care to the people we care for.
References 1. Centers for Medicare and Medicaid Services, HHS. Medicare program; hospital inpatient prospective payment systems for acute care hospitals and the longterm care hospital prospective payment system and fiscal year 2015 rates; quality reporting requirements for specific providers; reasonable compensation equivalents for physician services in excluded hospitals and certain teaching hospitals; provider administrative appeals and judicial review; enforcement provisions for organ transplant centers; and electronic health record (EHR) incentive program. Final rule. Federal Register. 2014;79: 49853-50536. 2. P.F. White, H. Kehlet, Improving pain management: are we jumping from the frying pan into the fire? Anesth. Analg. 105 (2007) 10–12. 3. A. Lembke, Why doctors prescribe opioids to known opioid abusers, N. Engl. J. Med. 367 (2012) 1580–1581. 4. A. Zgierska, M. Miller, D. Rabago, Patient satisfaction, prescription drug abuse, and potential unintended consequences, JAMA 307 (2012) 1377–1378. 5. P.E. Frasco, J. Sprung, T.L. Trentman, The impact of the joint commission for accreditation of healthcare organizations pain initiative on perioperative opiate consumption and recovery room length of stay, Anesth. Analg. 100 (2005) 162–168. 6. H. Vila Jr., R.A. Smith, M.J. Augustyniak, et al., The efficacy and safety of pain management before and after implementation of hospital-wide pain management standards: is patient safety compromised by treatment based solely on numerical pain ratings? Anesth. Analg. 101 (2005) 474–480. 7. G.M. Oderda, R.S. Evans, J. Lloyd, et al., Cost of opioid-related adverse drug events in surgical patients, J. Pain Symptom Manag. 25 (2003) 276–283. 8. L.A. Giordano, M.N. Elliott, E. Goldstein, W.G. Lehrman, P.A. Spencer, Development, implementation, and public reporting of the HCAHPS survey, Med. Care Res. Rev. 67 (2010) 27–37.
8
M.A. Ashburn, L.A. Fleisher / Healthcare 4 (2016) 6–8
9. Pamela E Macintyre, S Schug, D Scott, E Visser, S Walker (Eds.), Acute Pain Management: Scientific Evidence, Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine, Melborne, 2010, Third edition. 10. American Society of Anesthesiologists Task Force on Acute Pain Management, Practice guidelines for acute pain management in the perioperative setting: an updated report by the American Society of Anesthesiologists Task Force on Acute Pain Management, Anesthesiology 116 (2012) 248–273. 11. K. Kroenke, T. Stump, D.O. Clark, C.M. Callahan, C.J. McDonald, Symptoms in hospitalized patients: outcome and satisfaction with care, Am. J. Med. 107 (1999) 425–431. 12. M. Helfand, M. Freeman, Assessment and management of acute pain in adult medical inpatients: a systematic review, Pain Med. 10 (2009) 1183–1199. 13. M. Gonzalez-Fernandez, H. Aboumatar, D. Conti, A.M. Patel, M.A. Purvin, M. Hanna, Educational gaps among healthcare providers: an institution needs assessment to improve pain management for postsurgical patients, J. Opioid Manag. 10 (2014) 345–351. 14. Pennsylvania Patient Safety Authority, Adverse drug events with HYDROmorphone: How preventable are they? Pa. Patient Saf. Advis. 7 (2010) 69–75. 15. M.C. Gaunt, D. Alghandi, M. Grissinger, Results of the 2013-2014 opioid knowledgeassessment: progress seen, but room for improvement, Pa. Patient Saf. Advis. 11 (2014) 124–130. 16. The Joint Commission. Safe use of opioids in hospitals. Sentinel Event Alert: The Joint Commission; 2012. 17. M. Schwenkglenks, H.J. Gerbershagen, R.S. Taylor, et al., Correlates of satisfaction with pain treatment in the acute postoperative period: results from the international PAIN OUT registry, Pain 155 (2014) 1401–1411. 18. DP Mather, W Wong, P Woo, et al., Perioperative factors associated with HCAHPS responses of 2,758 surgical patients, Pain Med. (2014). 19. P.A. Bovier, A. Charvet, A. Cleopas, N. Vogt, T.V. Perneger, Self-reported management of pain in hospitalized patients: link between process and outcome, Am. J. Med. 117 (2004) 569–574. 20. N.A. Desbiens, A.W. Wu, S.K. Broste, et al., Pain and satisfaction with pain control in seriously ill hospitalized adults: findings from the SUPPORT research investigations. For the SUPPORT investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment, Crit. Care Med. 24 (1996) 1953–1961. 21. C.T. Whelan, L. Jin, D. Meltzer, Pain and satisfaction with pain control in hospitalized medical patients: no such thing as low risk, Arch. Intern. Med. 164 (2004) 175–180.
22. R.M. Andrews, A.L. Browne, F. Wood, S.A. Schug, Predictors of patient satisfaction with pain management and improvement 3 months after burn injury, J. Burn Care Res. 33 (2012) 442–452. 23. G. Haller, T. Agoritsas, C. Luthy, V. Piguet, A.C. Griesser, T. Perneger, Collaborative quality improvement to manage pain in acute care hospitals, Pain Med. 12 (2011) 138–147. 24. K.R. Archer, R.C. Castillo, S.T. Wegener, C.M. Abraham, W.T. Obremskey, Pain and satisfaction in hospitalized trauma patients: the importance of self-efficacy and psychological distress, J. Trauma Acute Care Surg. 72 (2012) 1068–1077. 25. L.B. Ready, Acute pain: lessons learned from 25,000 patients, Reg. Anesth. Pain Med. 24 (1999) 499–505. 26. L.B. Ready, R. Oden, H.S. Chadwick, et al., Development of an anesthesiologybased postoperative pain management service, Anesthesiology 68 (1988) 100–106.
Conflict of interest disclosure statement This statement accompanies the article "Does assessment of patient satisfaction with pain care lead to patient harm?" authored by Michael A. Ashburn and co-authored by Lee A. Fleisher and submitted to Healthcare as an original article. Below all authors have disclosed relevant commercial associations that might pose a conflict of interest: Consultant arrangements: None. Stock/other equity ownership: None. Patent licensing arrangements: None. Grants/research support: None. Employment: None. Speakers' bureau: None. Expert witness: None. Other: None.