People often suffer from worries about undertreating their pain in various medical settings. Doctors have the ethical responsibility to treat their patients’ pain and suffering to the degree that it can be managed.  

There is an increasing need for pain management programs to help people with varying degrees and qualities of pain.

There are four critical components to creating a successful pain management program.  They include:

1. An institutional commitment to relieving pain
2. An interdisciplinary team to handle all aspects of pain
3. Education of patients and staff around pain management
4. Continuous quality improvement of pain management

The first step is to identify those institutional leaders in the system who can set the commitment level of the entire program.  These will help identify a philosophy around pain management.  A task force of interested people should be developed to help create a good pain management program.

The program needs a mission statement that reflects its opinion and goals regarding pain management. Ideally, a mission statement can help define the goals of maximally treating pain to the patient’s benefit.

Standards of pain must be established, which include the various plans of care, such as:

• Recognizing that all patients have the right to appropriate assessment and management of pain.
• Finding out the nature and intensity of a patient’s pain
• Recording the results of pain interventions over time
• Determining and assuring that all staff members are on board with pain relief and prevention
• Assuring that staff members are competent in understanding and treating pain
• Teaching new staff members how to deal with pain
• Having established policies and procedures in place when it comes to dealing with pain
• Making sure that pain doesn’t interfere with the rehabilitation of patients
• Educating patients and families regarding pain care and management
• Collect data regarding the effectiveness of pain management in all cases
• Address patient’s needs for homecare management of pain after discharge from a facility

Pain is multidimensional and so needs a multi-disciplinary team to manage it.  Successful pain management addresses the patient’s psychological, physiological, spiritual, cultural, and social needs when dealing with pain.

A multi-disciplinary team has several functions, including:

• Assisting the organization in developing policies and procedures around pain management so that all types of pain can be managed.
• Serving patients by recognizing and integrating all the different dimensions of pain.
• Providing support to families dealing with a family member suffering from chronic pain.
• Addressing community needs regarding education around pain management, drug addiction, communication with health professionals, and holistic approaches to managing pain.

A good pain management team includes professionals who meet to discuss pain issues and have social workers, pastoral care professionals, physical therapists, occupational therapists, dieticians, pharmacists, nurses, physicians, and educators.   The role of the team includes the following:

• Identify the needs of patients, families, and staff when it comes to pain management
• Collaborating with providers to maximally treat pain
• To assure that pain relief goals are met
• To promote changes as defined by continuous quality improvement and monitoring.

Team members each have a role in dealing with a patient’s pain, which includes assessing the needs of the patient in all modalities, using standardized tools to define pain, summarizing findings for the physician, reviewing the treatment plan, including both pharmacological and non-pharmacological management of pain, communicating the plan of care to others, visiting the patient to assess progress, assessing for ongoing pain-relieving needs, and measuring outcomes of pain-relieving practices.

Developing an Educational/Action Plan

To address an educational/action plan around an individual’s pain, the following core areas need to be addressed:

• The physiology of pain
• The assessment of pain
• The various rating scales for pain
• The types of analgesics used
• Management of symptoms
• Issues related to spirituality and psychosocial needs
• Pain management in elderly persons
• Barriers to pain management
• Ethics of pain management
• Non-pharmacological interventions

Ways of assuring that the organization fully understands the impact of pain on the individual include having an exceptional week designed around understanding pain management, having poster presentations on pain management, or having a portable educational cart that helps teach patients and staff about pain management.  A bulletin board can address pain management issues so that the team is constantly reminded of how pain can be managed.

The team must always practice continuous quality improvement so that changes can continually be made that address patient needs when it comes to pain management.  This means that there should be ongoing data gathering to ensure that pain is constantly being handled.

Editor’s Note: This page has been updated for accuracy and relevancy [cha 4.15.22]

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