The Joint Commission recently released a report to help hospitals better understand and comply with new pain assessment and management standards that will be applicable to all Joint Commission-accredited hospitals, effective January 1, 2018.
An independent, not-for-profit organization, The Joint Commission accredits and certifies over 21,000 health care organizations and programs in the United States. Joint Commission accreditation and certification is recognized nationwide as a symbol of quality that reflects an organization’s commitment to meeting certain performance standards.
The August 29, 2017, issue of the R3 Report highlighted the new pain assessment and management standards for hospitals that are accredited by the Joint Commission. The standards are in the following chapters of the hospital accreditation manual and are designed to improve the quality and safety of care provided by Joint Commission-accredited hospitals: Leadership; Medical Staff; Provision of Care, Treatment and Services; and Performance Improvement.
The new requirements include the following:
- That the hospital has a leader or leadership team that is responsible for pain management and safe opioid prescribing and developing and monitoring performance improvement activities;
- That the hospital provides nonpharmacologic pain treatment modalities;
- That the hospital provides staff and licensed independent practitioners with educational resources and programs to improve pain assessment, pain management, and the safe use of opioid medications based on the identified needs of its patient population;
- That the hospital provides information to staff and licensed independent practitioners on available services for consultation and referral of patients with complex pain management needs;
- That the hospital identifies opioid treatment programs that can be used for patient referrals;
- That the hospital facilitates practitioner and pharmacist access to the Prescription Drug Monitoring Program (PDMP) databases;
- That hospital leadership work with its clinical staff to identify and acquire the equipment needed to monitor patients who are at high risk for adverse outcomes from opioid treatment;
- That the medical staff is actively involved in pain assessment, pain management, and safe opioid prescribing through the following: participating in the establishment of protocols and quality metrics, and reviewing performance improvement data;
- That the hospital has defined criteria to screen, assess, and reassess pain that are consistent with the patient’s age, condition, and ability to understand;
- That the hospital screen patients for pain during emergency department visits and at the time of admission;
- That the hospital treats the patient’s pain or refers the patient for treatment, whether it be nonpharmacologic, pharmacologic, or a combination of approaches;
- That the hospital develops a pain treatment plan based on evidence-based practices and the patient’s clinical condition, past medical history, and pain management goals;
- That the hospital monitors patients identified as being high risk for adverse outcomes related to opioid treatment;
- That the hospital reassesses and responds to the patient’s pain through the following: (1) evaluation and documentation of response(s) to pain intervention(s), (2) progress toward pain management goals including functional ability (for example, ability to take a deep breath, turn in bed, walk with improved pain control), (3) side effects of treatment, and (4) risk factors for adverse events caused by the treatment;
- That the hospital collects data on pain assessment and pain management including types of interventions and effectiveness;
- That the hospital analyzes data collected on pain assessment and pain management to identify areas that need change to increase safety and quality for patients; and
- That the hospital monitors the use of opioids to determine if they are being used safely (i.e., the tracking of adverse events such as respiratory depression, naloxone use, and the duration and dose of opioid prescriptions).