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The joint commission for the accreditation of Health Care Organizations (JCAHO), which accredits most of the nation’s hospitals and thousands of other health care organizations, has begun monitoring how well these facilities assess and treat pain, marking another positive step toward the recognition for better pain management.
The new pain management standards are included in the 2000-2001 standards manuals, and JCAHO surveyors have begun assessing compliance since they took affect Jan. 1. JCAHO’s new pain management standards were welcomed by clinicians, pain experts, patients, and their families who have seen pain gone untreated or undertreated for decades.
"These changes have the power to improve the quality of life for millions and millions of Americans," said June L. Dahl, PhD, Professor of Pharmacology at the University of Wisconsin Medical School and President of the American Alliance of Cancer Pain Initiatives (AACPI). "This is a great victory for cancer patients in particular whose pain is often undertreated. Many caregivers, particularly those involved in cancer treatment, have been challenging health care leaders for years about the need to assess and treat patients’ pain better."
Under the new JCAHO standards, patients should be asked about pain and the intensity of the pain, including rating it on a simple "0 to 10" scale. Doctors and nurses will be expected to treat the patients’ pain and continue to assess treatment during and after hospitalization.
Studies show that an estimated 70% of people with cancer experience significant pain, while fewer than half receive adequate pain treatment. Fifty million Americans suffer from chronic pain, and four out of 10 people with moderate to severe chronic pain do not receive adequate relief. "The standards acknowledge that pain is a condition that needs explicit attention," said Carole Patterson, MN, RN, Director of the Standards Interpretation Unit of JCAHO. "Research shows that surgical pain and pain at the end of life, such as cancer pain, has not been managed well. Therefore, these standards should have a significant impact on pain management for patients."
The AACPI and the nearly 50 State Cancer Pain Initiatives headed by nurses, physicians, pharmacists, social workers, and researchers have long been advocates for better pain control in the nation’s health care system, and see the new standards as a milestone in efforts to overcome barriers to effective pain relief.
Today’s move will not affect all hospitals, nursing homes, and other facilities—only those accredited by the JCAHO. The JCAHO accredits 80% of the nation’s hospitals that control 98% of the hospital beds.
"Undertreating pain has been and still is bad medicine, and is often based on unfounded fear, ignorance or miscommunication by health care professionals and patients," Dahl said. "Hopefully, the new standards will begin to change this."