Understanding the Quality Measures and Risk Adjustment了解质量的措施与风险调整.pptVIP

Improve Your Pain Management Using a Quality Improvement Approach Objectives Understand FOCUS-PDSA quality improvement process Apply these concepts to improvement in pain management Identify facility opportunities for pain management improvement Develop pain management action plan using FOCUS-PDSA concepts Why Focus on Pain? Pain Effects in the Elderly Impairs mobility: slows rehab Decreases socialization Increases depression and sleep disturbances Contributes to cognitive impairment Contributes to inadequate food intake and malnutrition Increases morbidity Common Types of Pain in the Elderly Acute: surgical, medical, musculoskeletal Chronic: surgical, medical arthritic, neuropathic, musculoskeletal Cancer: breast, prostate, colon, lung, acute and chronic Pain Quality Measures Short stay “post-acute” population Percentage of residents with moderate or excruciating pain on the 14-day prospective payment system (PPS) Minimum Data Set (MDS) assessments Long “chronic” stay population Percentage of residents with moderate or excruciating pain on non-PPS and non-admission assessments Where Do We Start? Model for Improvement FOCUS – PDSA Find a process to improve Organize a team that knows the process Clarify current knowledge of the process Understand causes of process variation Select the process improvement FOCUS – PDSA Find a process to improve Clarify Current Knowledge of the Process Key Steps to Effective Pain Management Screen residents routinely for pain Complete assessment for residents found to have pain on screening Identify resident’s goal for pain management Address pharmacologic and non-pharmacologic treatments in plan of care Monitor effectiveness of treatments in meeting resident’s goal Revise plan of care based on monitoring Pain Management Flow Chart Screen Residents Consider pain as the fifth vital sign Use a pain scale for screening Identify a pain scale for verbal, cognitively intact residents Identify a pain scale for non-verb