Do you still measure your patients' pain on a scale of 0 to 10? A team of staffers from across a broad spectrum of disciplines at University of Utah Health Care have developed what they say is an approach that provides deeper insights and allows clinicians and others to make better decisions about treatments. And it improves patient satisfaction.


The new process is described in the university's 2012 Nursing Report, called "Cultivating Collaboration," which focuses on "10 new ways to connect ideas and grow the future of nursing." I'll be writing about other valuable lessons from the report in an upcoming post, but I wanted to start with the pain measurement initiative because it's straightforward and easily replicable by other hospitals and health care systems.

CNO Margaret Pearce wanted to raise patient satisfaction pain scores, so she convened a team consisting of nurses, pharmacists, physicians, educators, advanced practice nurses and physical therapists to consider the best way to measure patients' pain. Two colleagues from the university's pain research center joined the effort.

After a thorough assessment of the issue and lots of conversation that drew on the varied expertise of all participants, the team came up with a series of questions designed to replace the commonly used 0-10 pain scale. Nurses were instructed to ask those questions in a casual and natural manner rather than using a strict checklist format.

"Asking a patient to describe their experience opens up a dialogue, so that a therapeutic relationship can form," said Deborah Watkins, a clinical nurse educator. Added Brenda Gulliver, quality improvement specialist, "Everything we did was an effort to move away from the drive-by pain assessment."

IT staff were brought on board to develop the best way to document the patients' responses so, as the report states, "they could create a fully realized, easy-to-use tool that integrated seamlessly with the hospital's regular documentation workflow."

The new method is a big success. Example: In one quarter after the pilot was launched, patient satisfaction pain scores soared from the 45th percentile to the 92nd percentile on the pilot units.

Team members have high hopes this new way of measuring pain will "have ripple effects far beyond our hospital walls, with nurses everywhere tossing out numbers in favor of conversations."

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