1. Implementation of pain best practices as part of the spinal cord injury knowledge mobilization network
- Author
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JoAnne Savoie, Shane McCullum, Jeremy Slayter, Dalton L. Wolfe, and Colleen O'Connell
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Psychological intervention ,Context (language use) ,03 medical and health sciences ,0302 clinical medicine ,Patient satisfaction ,Patient Education as Topic ,Pain assessment ,Humans ,Pain Management ,Medicine ,030212 general & internal medicine ,Spinal cord injury ,Research Articles ,Spinal Cord Injuries ,Neurorehabilitation ,Aged ,Rehabilitation ,business.industry ,030503 health policy & services ,Health Plan Implementation ,Retrospective cohort study ,medicine.disease ,Knowledge Management ,Patient Satisfaction ,Practice Guidelines as Topic ,Physical therapy ,Female ,Guideline Adherence ,Neurology (clinical) ,0305 other medical science ,business - Abstract
Context/objective: The spinal cord injury (SCI) knowledge mobilization network (KMN) is a community of practice formed in 2011 as part of a national best practice implementation (BPI) effort to improve SCI care. This study objective was to determine whether completion and documentation of pain practices could be improved in a neurorehabilitation setting using the KMN implementation approach. Design: Single site, pre–post intervention study. Setting: Neurorehabilitation hospital. Participants: Twenty sequential consenting inpatients with SCI, with retrospective comparative analysis of 50 sequential SCI admissions pre-KMN. Interventions: A local Site Implementation Team (SIT) was formed to develop an implementation plan, including acceptable timeframes for completion and documentation of four specific pain best practices: (1) pain assessment on admission, (2) development of an Inter-Professional Pain Treatment Plan (IPTP), (3) pain monitoring throughout admission, and (4) a pain discharge plan. Outcomes: Provider adherences to pain best practices were the primary outcomes. The secondary outcome was patient satisfaction. Results: Provider adherence for most outcomes exceeded 70% completion within acceptable timeframes, with improvements found for all outcomes as compared to the retrospective cohort. Notably, pain education as part of the IPTP improved from 12% completion to 74%, documenting pain onset from 4.5% to 80% and pain discharge plan from 40% to 74%. Overall, participants were satisfied with their pain management. Conclusions: Pain best practices were more consistently documented after the KMN implementation. Pain practices in all four areas have now been expanded to all inpatient diagnoses using the same forms and framework created in the implementation process.
- Published
- 2019