Hospice and Palliative Care - Pain Assessment
Identifying Attributes
Care Settings
Country
Publishing Organisation
Type of Quality Indicator
IOM Quality Dimension
Domain
Defining Attributes
Definition
For patients who screened positive for moderate to severe pain on admission, the percent with any physician/clinical assessment within 24 hours of screening.
Numerator
Patients who received a comprehensive clinical assessment to determine the severity, aetiology and impact of their pain within 24 hours of screening positive for pain. Patients with a comprehensive clinical assessment including at least 5 of the following 7 characteristics of the pain: location, severity, character, duration, frequency, what relieves or worsens the pain, and the effect on function or quality of life.
Denominator
Patients enrolled in hospice OR receiving palliative care who report pain when pain screening is done on the admission evaluation / initial encounter.
Exclusions
Denominator Exclusions: Patients with length of stay < 1 day in palliative care or < 7 days in hospice, patients who were not screened for pain. Patients who screen negative for pain are excluded from the denominator. Calculations required to perform denominator exclusions: length of stay= discharge date - date of initial encounter.
Use of Risk Adjustment
Risk Adjustments
None
Stratifications
None
Collection and Reporting Attributes
Type of Data Collection
Data Collection Methods
Electronic Clinical Data; Electronic Health Record. Data collection using a structured chart abstraction tool and operational definition.
Frequency of Data Collection
Frequency of Data Collection in Days
Reporting Methods
The Level of Analysis is performed at the Clinician (Group/Practice) and Facility levels.
Reporting Frequency
Reporting Frequency in Days
Indicator Has Recommended Targets
Source and Reference Attributes
Evidence Source
Indicator development: Anna P. Schenck, Franziska S. Rokoske, Danielle D. Durham, John G. Cagle, and Laura C. Hanson. The PEACE Project: Identification of Quality Measures for Hospice and Palliative Care.Journal of Palliative Medicine.Dec 2010.1451-1459.http://doi.org/10.1089/jpm.2010.0238 Indicator feasbility/testing: Hanson LC, Rowe C, Wessell K, et al. Measuring palliative care quality for seriously ill hospitalized patients. J Palliat Med 2012;15(7):798-804. PEACE website: www.med.unc.edu/pcare/about-palliative-care/resources/peace-quality-measures/
Technical Specifications
Full specifications were taken from NQF documentation available here: www.med.unc.edu/pcare/wp-content/uploads/sites/503/2017/11/nqf-pain-assessment.pdf Unable to locate from PEACE program literaure. Limited specification details available in Table 2 of Hanson LC, Rowe C, Wessell K, et al. Measuring palliative care quality for seriously ill hospitalized patients. J Palliat Med 2012;15(7):798-804. PEACE website: www.med.unc.edu/pcare/about-palliative-care/resources/peace-quality-measures/
Link to Measurement Tools
Linked to NQF measure #1637.