Presented at the 2013 AAPM Annual Meeting « Back

Reciprocating Quality Analysis Project to Review Inpatient Pain Management: Project Design And Implementation

Robert Kent, DO MHA, rkent@health.usf.edu¹, (1) University of South Florida, Tampa, Florida

Introduction: This project is the development and result of a quality assessment program currently being performed at James A. Haley Veterans Administration Hospital looking at inpatient amputee patients undergoing acute rehabilitation, as well as designing a foundation for the project that will be able to be used over multiple years for ongoing quality assessment in the inpatient amputee program. This year, specifically, the quality assessment program has focused on the first two initiatives of pain management and patient education. Qualitative and quantitative analysis was used to identify strengths, shortcomings and possible solutions and barriers to change. Key faculty involved with the care of inpatient amputees, as well as patients, were interviewed, identifying areas of concern and strength. While the primary goal of this project was to improve patient care, the secondary goal was to effectively develop a reciprocating multi-year model quality assessment project that can be performed by residents within our program to meet and exceed current ACGME recommendations for involvement in ongoing quality analysis. The reciprocating model can be applied to any direct patient care program for multi-year improvement in patient outcomes in a more efficient manner than the standard annual quality analysis investigations. References: 1) National Guideline Clearinghouse, VA/DoD clinical practice guideline for rehabilitation of lower limb amputation. (n.d.). National Guideline Clearinghouse, Home. Retrieved November 11, 2011, from http://www.ngc.gov/content.aspx?id=11758. 2) Chao, S. (2007). Advancing quality improvement research challenges and opportunities - workshop summary. Washington, D.C.: National Academies Press. 3) Dyer, D., Bouman, B., Davey, M., & Ismond, K. (2008). An Intervention Program to Reduce Falls for Adult In-Patients Following Major Lower Limb Amputation. Healthcare Quarterly, 11, 117-121. 4) Ehde, D., Czerniecki, J., Smith, D., Campbell, K., Edwards, T., Jensen, M., et al. (2000). Chronic phantom sensations, phantom limb pain, and other regional pain after lower limb amputation. Archives of Physical Medicine and Rehabilitation, 81, 1039-44. 5) Gnatz, S., Brown, S., Atchinson, J., Taub, N., & Worsowicz, G. (1988). Pain rehabilitation. American Academy of Physical Medicine and Rehabilitation, 79, 74-46. 6) Pasquina, P., Bryant, P., Huang, M., Roberts, T., Nelson, V., & Flood, K. (2006). Advances in Amputee Care. Archives of Physical Medicine and Rehabilitation, 87, S34-43. 7) Poorman, C., Susskind, O., Menetrez, J., Moore, J., Patterson, E., Scoville, C., et al. (2010). The Next Step: The Rehabilitation Journey After Lower Limb Amputation. Washington D.C.: Veterans Affairs and Department of Defense collaboration. 8) Sigford, B. (2010). Paradigm shift for VA amputation care. Journal of Rehabilitation Research and Development, 47, 15-19.

Funding: None.