HSS Journal

, Volume 6, Issue 1, pp 61–65

Creation of a Novel Recuperative Pain Medicine Service to Optimize Postoperative Analgesia and Enhance Patient Satisfaction

  • Brian D. Philips
  • Spencer S. Liu
  • Barbara Wukovits
  • Friedrich Boettner
  • Seth Waldman
  • Gregory Liguori
  • Stephanie Goldberg
  • Lisa Goldstein
  • Joanne Melia
  • Marion Hare
  • Laura Jasphey
  • Sharyn Tondel
 

Abstract

Many patients have difficulty with pain control after transition from patient-controlled analgesia modalities to oral analgesics. The creation of a Recuperative Pain Medicine (RPM) service was intended to bridge this gap in pain management at the Hospital for Special Surgery. Specific goals were to improve patient and staff satisfaction with management of postoperative oral analgesics by improving clinical care, administrative policies, and patient and staff education. Primary outcome measures for improved satisfaction were Press Ganey surveys and staff surveys. From inception in Aug 2007 to Dec 2008, RPM has seen 6,305 patients for discharge planning and education and 997 patients for pain management consultation. Administrative and educational accomplishments have included creation of a patient “Helpline” for emergent phone questions regarding postdischarge home pain medications, a policy for prescribing pain medications for home discharge, patient education booklets, a pain management webpage on the Hospital for Special Surgery website, and direct education of staff. Press Ganey measurements of patient satisfaction increased from 87th percentile up to the 99th percentile among peer institutions since the implementation of RPM. Staff satisfaction was 92% positive regarding the RPM service’s function and patient management. An RPM appears to be an effective means to optimize postoperative pain management after transition off patient-controlled analgesia devices. Further research is needed to ascertain the exact cost–benefit and potential impact on postoperative quality-of-life measurements.

Keywords

orthopedic surgery pain services patient satisfaction postoperative analgesia postoperative outcomes 

References

  1. 1.
    Liu SS, Wu CL (2007) The effect of analgesic technique on postoperative patient-reported outcomes including analgesia: a systematic review. Anesth. Analg. 105:789–808CrossRefPubMedGoogle Scholar
  2. 2.
    Herrera FJ, Wong J, Chung F (2007) A systematic review of postoperative recovery outcomes measurements after ambulatory surgery. Anesth. Analg. 105:63–69CrossRefPubMedGoogle Scholar
  3. 3.
    Apfelbaum JL, Chen C, Mehta SS, Gan TJ (2003) Postoperative pain experience: results from a national survey suggest postoperative pain continues to be under managed. Anesth. Analg. 97:534–540CrossRefPubMedGoogle Scholar
  4. 4.
    Wu CL, Naqibuddin M, Rowlingson AJ, Lietman SA, Jermyn RM, Fleisher LA (2003) The effect of pain on health-related quality of life in the immediate postoperative period. Anesth. Analg. 97:1078–1108CrossRefPubMedGoogle Scholar
  5. 5.
    Liu SS, Wu CL (2007) Effect of postoperative analgesia on major postoperative complications: a systematic update of the evidence. Anesth. Analg. 104:689–702CrossRefPubMedGoogle Scholar
  6. 6.
    Werner MU, Søholm L, Rotbøll-Nielsen P, Kehlet H (2002) Does an acute pain service improve postoperative outcome? Anesth. Analg. 95:1361–1372CrossRefPubMedGoogle Scholar
  7. 7.
    Courtenay M, Carey N (2008) The impact and effectiveness of nurse-led care in the management of acute and chronic pain: a review of literature. J. Clin. Nurs. 17(15):2001–2013CrossRefPubMedGoogle Scholar

Copyright information

© Hospital for Special Surgery 2009

Authors and Affiliations

  • Brian D. Philips
    • 1
  • Spencer S. Liu
    • 1
  • Barbara Wukovits
    • 1
  • Friedrich Boettner
    • 1
  • Seth Waldman
    • 1
  • Gregory Liguori
    • 1
  • Stephanie Goldberg
    • 1
  • Lisa Goldstein
    • 1
  • Joanne Melia
    • 1
  • Marion Hare
    • 1
  • Laura Jasphey
    • 1
  • Sharyn Tondel
    • 1
  1. 1.Hospital for Special SurgeryNew YorkUSA

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