Pain is a major health and economic issue in the United States with millions of Americans currently being impacted by chronic pain. Chronic pain affects more people than diabetes, coronary heart disease and stroke combined, and costs billions of dollars each year. Unrelieved pain often results in longer hospital stays, increased rates of hospitalization and outpatient visits, and can lead to the inability for patients to work. A major issue can only be managed by an interdisciplinary team approach, not by individuals simply working harder.
Defining the Pain Management Team
Historically, a patient’s pain was addressed by individual health care providers, usually a physician. Since the presence of pain affects many aspects, including an individuals’ functioning, psychosocial and behavioral factors as well as the extent of their underlying physical pathology, it is critical that a number of health care professionals and their teams be involved.
The successful interdisciplinary team approach begins at the time of admission when the complete team shares ideas on how to manage the patient’s pain. The team members should have complementary roles that result in enhanced patient care. Each discipline involved on this team should offer a valuable base of knowledge and a discrete skillset. The team should consist of anyone that is involved in the patient’s plan of care, which could include:
- RN, LPN, Aide, PT, PTA, SLP, OT, COTA, MSW,
- PRN staff,
- Patient, and
- Patient representative, if any and/or caregivers
The Team’s Approach to Improving Patient Outcomes
To effectively care for the patient, open and frequent communication is critical. The communication must entail a holistic approach. It should not be directed toward just an isolated body part or symptom, and it must include the physical, emotional, social and psychological aspects. In addition, brainstorming should be included about what is working as well as what is not working for the patient. Team members must communicate to each other whenever the status of the plan needs to be revised because the patient’s pain and/or effects of medications have changed.
Finally, it is crucial that the team is diligent about documenting all of this information in the clinical record.
Next, not only the team, but the patient as well as any caregiver(s) need to understand the patient’s goals, any barriers to improving patient outcomes, and strategies that will be successful in the patient’s environment. The care must be patient-centered, but also the team must be very cognizant of the family, representative, if any, and/or caregiver(s). Efforts must be made to empower not only the patient, but also caregiver(s) and/or significant other.
In order to improve the patient’s pain outcomes, every team member must be each other’s eyes and ears and work together. In other words, if one team member sees that a patient’s pain is not relieved with pain medication, that team member must report it to the rest of the team in order to identify if the problem continues, if there are alternate interventions to use, and/or determine if the physician needs to be contacted. A unified message should be provided to a patient, caregiver(s) and/or significant other, ensuring that the team members reinforce the methods being used across the various disciplines.
Every team member must be familiar with the overall treatment plan, the methods and modalities being used, as well as the goals of each discipline and how they contribute to the overall goals of the patient (i.e. reduction in pain, patient satisfaction). Although there are common goals for the entire team, each discipline may target specific issues. For example, the pharmacist may focus on safety, limiting adverse events, and monitoring for adverse events or misuse. The physical therapist may be focused on low impact exercises that increase mobility and range of motion and decrease pain. Each team member must ensure the goals are clear, focused, realistic and measurable. Finally, progress toward achieving these goals must be monitored.
We Can Help with Your Pain Management Team
Our team at 5 Star Consultants is very knowledgeable about pain management. One of the first steps in treating it effectively is to have an interdisciplinary team. We can help ensure your team is aligned and patients’ pain management is dealt with effectively. We offer multiple training options regarding this topic as well as many other home health focused subjects. For further information, please feel free to contact us at [email protected] or 866-428-4040.