Long-term sustainability of a quality improvement program on cancer pain management: a complex intervention in an inpatient setting

Tumori. 2020 Feb;106(1):25-32. doi: 10.1177/0300891619869513. Epub 2019 Aug 28.

Abstract

Background: Several approaches towards pain control for admitted cancer patients have been suggested by the literature without achieving satisfactory results. In this quality improvement project, we proposed a multicomponent intervention.

Measures: A set of indicators was established for each component of the project. The feasibility of both the intervention and its evaluation system was measured. According to the literature review and the analysis of the local context, 5 active components were identified, piloted, and assessed: training of ward professionals, education of patients and nonprofessional caregivers, regular pain assessment, specialist-level pain consultation procedures, and involvement of hospital management.

Results: Multiprofessional training programs with daily discussions, daily pain assessment, and a readily available specialized palliative care service seem to be the active components of this complex intervention. The quality improvement project achieved 2 years sustainability.

Conclusion: Consolidated educational and organizational methodologies support the feasibility of this complex intervention.

Keywords: Palliative care; complex intervention; pain management.

Publication types

  • Meta-Analysis

MeSH terms

  • Cancer Pain / diagnosis
  • Cancer Pain / epidemiology*
  • Cancer Pain / therapy
  • Caregivers
  • Disease Management
  • Female
  • Follow-Up Studies
  • Health Care Surveys
  • Humans
  • Inpatients*
  • Male
  • Models, Theoretical
  • Outcome Assessment, Health Care
  • Pain Management* / methods
  • Pain Management* / standards
  • Pain Measurement* / methods
  • Pain Measurement* / standards
  • Patient Education as Topic
  • Quality Improvement*
  • Referral and Consultation