Pain management in ER may significantly impact patient satisfaction

CAL/AAEM News Service at
Sun Aug 28 19:19:02 PDT 2016



August 5, 2016


Pain management in ER may significantly impact patient satisfaction






by Paige Minemyer


Hospitals can use patient experience survey responses to target needed
improvements, but one common question often concerns clinicians: "Did staff
members effectively treat your pain?"


Emergency room patients in particular have high expectations for pain
management, according to an article in The New York Times, and when those
expectations aren't met, hospital patient satisfaction scores can suffer. In
the wake of widespread opioid addiction, health providers are cutting back
on prescriptions for such pain medications, despite patient demand. The ED
is a particular target for such cutbacks, as many emergency room patients
arrive in acute pain.


Patients expect their pain to be treated fully, according to the article,
and think prescriptions for medications like opioids are a logical quick
fix. And doctors like S. Michael Keller, medical director of the ED at
Marion General Hospital in Indiana, says patients react negatively when
doctors deny them the painkillers. "I've been swung at, spit on; I've been
yelled at, all because I haven't given a patient what they came in
demanding," Keller told the newspaper.


Facilities like Marion General are instituting tough opioid prescription
guidelines cut the prescribing rate of such drugs, NYT reported. Marion
General's program cut the rate of opioid prescriptions in its emergency room
by half over the course of 18 months. Shortly thereafter, the hospital's
patient satisfaction scores dropped dramatically. Its emergency room fell
from the 58th percentile to the 14th percentile among the 1,100 ERs that use
the same survey, according to the article, and its overall satisfaction went
from the 61st percentile to the 30th.


But defenders of the current surveys told NYT that Marion General's case is
not reflective of the process as a whole. Recent study data has suggested
that hospitals place too much stock in patient satisfaction surveys,
FierceHealthcare previously reported, potentially to the detriment of care


Despite the potential negative response from patients, national
organizations like the Centers for Disease Control and Prevention have
hammered the point that hospitals should use caution to avoid unnecessary
opioid prescriptions.




Jeff Wells
Deputy Editor, CAL/AAEM News Service


Brian Potts MD, MBA
Managing Editor, CAL/AAEM News Service

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