Is Your Pain Being Properly Assessed and Managed?
Updated April 24, 2015.
- Standard
RI.1.2.9
Patients have the right to appropriate assessment and management of pain.
Intent of RI.1.2.9
Pain can be a common part of the patient experience; unrelieved pain has adverse physical and psychological effects. The patient's right to pain management is respected and supported. The health care organization plans, supports, and coordinates activities and resources to assure the pain of all patients is recognized and addressed appropriately...
A two-year collaboration between the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and the University of Wisconsin - Madison Medical School produced standards for pain management that went into effect January 1, 2001, which are excerpted above. What IS JCAHO? JCAHO is the predominant health care standards-setting and accrediting organization in the U.S. Their mission is to continually improve the safety and quality of patient care by providing accreditation, education, and consultation services. For hospitals, outpatient clinics, nursing homes, health care networks, behavioral health care providers, and some other health care providers, JCAHO accreditation is key for Medicare certification, liability insurance, managed care contracts, state licensure requirements, and community confidence.
What drove the development of these standards? Predominantly, this one fact, as stated at the 19th Annual Meeting of the American Pain Society:
- Pain Is Undertreated Despite Years of Emphasis and Effective Therapies.
According to the report of that meeting, it was driven by "the reality that the undertreatment of pain is a major public health problem in the United States." These new standards require pain management to become an integral part of all treatment plans in nearly 18,000 accredited health care facilities. The standards are anticipated to dramatically impact the more than 120 million Americans dealing with pain. The standards call upon facilities to:
- Recognize patients' rights to pain control
- Screen for pain
- Perform a complete assessment when pain is present
- Record the assessment in a way that facilitates regular reassessment and follow-up
- Set a standard for monitoring and intervention
- Educate providers and assure staff competency
- Establish policies that support appropriate prescription or ordering of pain medicines
- Educate patients and families
- Include patient needs for symptom control in discharge planning
- Collect data to monitor the effectiveness and appropriateness of pain management
Now, when a patient's vital signs are checked - temperature, blood pressure, etc. - their level of pain will be assessed also. Adults will be asked, if they are in pain, to rate it on a scale of one to ten. Young children will be asked to demonstrate their pain level by drawing a picture. Proper pain relief is required to begin as soon as possible or facilities risk losing accreditation.
Dr. Russell Portenoy, pain medicine chairman at Beth Israel Medical Center in New York commented, "It's a watershed event. No one has ever promised patients no pain. But what JCAHO wants to do is promise people their pain will be assessed and managed in a state-of-the-art way."
These standards have been in effect since January of 2001, but reading many of our forum posts reveal that not all JCAHO accredited facilities are complying with them. If you find yourself in one of those facilities, seeking relief from a Migraine attack, severe headache, or other pain, if you are not asked to assess your pain, volunteer the information. Tell the person checking your vital signs or the person you're seeing for treatment how much pain you're in on a scale of one to ten. To close, I'm going to leave you with some very wise words from health care professionals:
- "This is not going to happen overnight. Patients are going to have to demand better care. Unrelieved pain has negative effects. Just like they need an antibiotic to treat infection, they need analgesics to treat their pain." Christine Miaskowski, nursing chair at the University of California, San Francisco, and American Pain Society president-elect.
- "People think it's like an 11th commandment: 'Thou had surgery, thou should have pain.' ... or that if you have cancer, you must have pain. Pain can be relieved." June Dahl, University of Wisconsin pain specialist.
- Standard
RI.1.2.9
Patients have the right to appropriate assessment and management of pain.
Intent of RI.1.2.9
Pain can be a common part of the patient experience; unrelieved pain has adverse physical and psychological effects. The patient's right to pain management is respected and supported. The health care organization plans, supports, and coordinates activities and resources to assure the pain of all patients is recognized and addressed appropriately...
A two-year collaboration between the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and the University of Wisconsin - Madison Medical School produced standards for pain management that went into effect January 1, 2001, which are excerpted above. What IS JCAHO? JCAHO is the predominant health care standards-setting and accrediting organization in the U.S. Their mission is to continually improve the safety and quality of patient care by providing accreditation, education, and consultation services. For hospitals, outpatient clinics, nursing homes, health care networks, behavioral health care providers, and some other health care providers, JCAHO accreditation is key for Medicare certification, liability insurance, managed care contracts, state licensure requirements, and community confidence.
What drove the development of these standards? Predominantly, this one fact, as stated at the 19th Annual Meeting of the American Pain Society:
- Pain Is Undertreated Despite Years of Emphasis and Effective Therapies.
According to the report of that meeting, it was driven by "the reality that the undertreatment of pain is a major public health problem in the United States." These new standards require pain management to become an integral part of all treatment plans in nearly 18,000 accredited health care facilities. The standards are anticipated to dramatically impact the more than 120 million Americans dealing with pain. The standards call upon facilities to:
- Recognize patients' rights to pain control
- Screen for pain
- Perform a complete assessment when pain is present
- Record the assessment in a way that facilitates regular reassessment and follow-up
- Set a standard for monitoring and intervention
- Educate providers and assure staff competency
- Establish policies that support appropriate prescription or ordering of pain medicines
- Educate patients and families
- Include patient needs for symptom control in discharge planning
- Collect data to monitor the effectiveness and appropriateness of pain management
Now, when a patient's vital signs are checked - temperature, blood pressure, etc. - their level of pain will be assessed also. Adults will be asked, if they are in pain, to rate it on a scale of one to ten. Young children will be asked to demonstrate their pain level by drawing a picture. Proper pain relief is required to begin as soon as possible or facilities risk losing accreditation.
Dr. Russell Portenoy, pain medicine chairman at Beth Israel Medical Center in New York commented, "It's a watershed event. No one has ever promised patients no pain. But what JCAHO wants to do is promise people their pain will be assessed and managed in a state-of-the-art way."
These standards have been in effect since January of 2001, but reading many of our forum posts reveal that not all JCAHO accredited facilities are complying with them. If you find yourself in one of those facilities, seeking relief from a Migraine attack, severe headache, or other pain, if you are not asked to assess your pain, volunteer the information. Tell the person checking your vital signs or the person you're seeing for treatment how much pain you're in on a scale of one to ten. To close, I'm going to leave you with some very wise words from health care professionals:
- "This is not going to happen overnight. Patients are going to have to demand better care. Unrelieved pain has negative effects. Just like they need an antibiotic to treat infection, they need analgesics to treat their pain." Christine Miaskowski, nursing chair at the University of California, San Francisco, and American Pain Society president-elect.
- "People think it's like an 11th commandment: 'Thou had surgery, thou should have pain.' ... or that if you have cancer, you must have pain. Pain can be relieved." June Dahl, University of Wisconsin pain specialist.
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