Enhancing Pain Assessment in Pediatric Sickle Cell Disease by Applying Quality Improvement Science

• DOI: 10.1037/cpp0000277
• Publication Date: 2019-05-16T13:59:03Z
• Authors: Soumitri Sil; Alana Goldstein-L...; Curtis Travers; Jordan Gilleland-...; Ashley Alexander; Beth Thompson; Anya Griffin; Courtney McCracken; Tamara New
• Keywords: 03 medical and health sciences; 0302 clinical medicine; 3. Good health

Objective:

Standardized pain assessment and interventions are recommended for youth hospitalized for pain. This quality improvement project integrated into a pediatric psychology service aimed to increase the standardized assessment of pain-related functional ability for youth with sickle cell disease (SCD) hospitalized for pain.

Method:

Children and adolescents ( n = 102) with SCD referred for psychology consultation for poor coping in response to pain during hospitalization completed a validated self-report of functional ability in addition to pain intensity during inpatient psychology visits. At the time of the quality initiative, routine and standardized assessment of pain-related functional ability was not integrated into standard clinical care. Plan–do–study–act cycles determined the feasibility and addressed common barriers of routine assessment and documentation of pain-related functional ability among youth with SCD during inpatient psychology visits with the primary goal to increase assessment of functional ability to at least 85% among patients with SCD referred for pediatric psychology consultation to address pain management within 1 year.

Results:

Through iterative plan–do–study–act cycles, routine assessment of pain-related functional ability during psychology visits increased to an average of 93% over the course of 12 months. Routine, standardized assessment of functional ability was considered feasible within a pediatric psychology service.

Conclusions/Lessons Learned:

This project supported the feasibility of integrating standardized assessment of functional ability to enhance pain assessment for youth hospitalized for SCD pain as part of routine clinical care in a multidisciplinary setting regardless of psychology referral.

Implications for Impact Statement This project illustrates that small systematic changes using an iterative quality improvement process can improve the assessment rates of pain-related functional ability for youth with sickle cell disease hospitalized for pain. Improved multidimensional pain assessment was feasible for clinicians to implement and for patients to complete.