The clock is running on new JCAHO standards for patient pain management.
The standards will be part of all accreditation evaluations performed after Jan. 1. They were born out of a two-year study by the Joint Commission on Accreditation of Healthcare Organizations and the medical school at the University of Wisconsin at Madison and funded by the Robert Wood Johnson Foundation.
Some 19,000 entities will have to meet the standards to achieve JCAHO accreditation in the next three years. This includes hospitals, providers of home care, hospice, behavioral healthcare and long-term care, and 1,000 accredited ambulatory care organizations.
Paul Schyve, M.D., JCAHO senior vice president, says the group put the pain standards in manuals last year. In a shakeout, 6,000 organizations visited in 2000 by accreditation teams were scored against the new guidelines but not marked down for lack of compliance.
"One of the things we observed was people were coming increasingly in compliance with the standards toward the end of the year," Schyve says.
Diana McDaniel, facility administrator for the Surgicare Outpatient Surgical Center in Evansville, Ind., says JCAHO's new standards are readily mastered.
McDaniel manages a five operating room facility used by 80 doctors.
The biggest change was formalizing and recording on a computer patient pain assessments that doctors and staffers had already been performing, she says.
"We put our program into place about six months ago to include pain as a vital sign," McDaniel says. "We ask our patients, 'On a scale of one to five, how is your pain?"'
That establishes a presurgical baseline. Patients are assessed after regaining consciousness and again after 24 hours and six weeks, McDaniel says. If they rate their pain level as five, "we continue to assess them every few minutes until the number goes down."