The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #63344

Claudia Fegan, MD, Ambulatory and Community Health Network, Cook County Bureau of Health, 1026 East 48th Street, Chicago, IL 60615, (312) 572-1278, singlepayer@aol.com, Silvio Glusman, MD, PhD, Division of Pain Management, John H. Stroger Hospital, John H. Stroger Hospital, 1835 W. Harrison, Chicago, IL 60612, and Angela Schrimpl, RN, Ambulatory and Community Health Network, Cook County Bureau of Health Services, 1900 W. Polk Street, Room 1220, Chicago, IL 60612.

PROBLEM: Pain is an under-recognized and under-treated clinical condition. ACTION: In an effort to launch a successful system-wide pain intervention program, the Cook County Bureau of Health Services with over 2 million visits a year, revised a commonly used survey to learn the baseline knowledge and beliefs about pain management of a variety of professionals. METHODS: Over 1800 surveys were distributed to attending physicians, residents, students, mid-level providers, nursing staff and clerks. A response rate of 54%was achieved with representation from all job categories and all Bureau sites. The survey consisted of 25 questions dealing with common beliefs about patients with pain as well as questions about specific types of analgesia. The surveys were quite remarkable for significant deficits in the appropriate use of opioids and judging the intensity or severity of pain. Also of note were misconceptions in treating pain in special populations, such as children, the elderly and those with sickle cell anemia. Suprisingly, these misconceptions and myths crossed disciplines. In other words, commonly held false beliefs were prevalent among attending physicians, residents, students, nurses and support staff,e.g. more than half of all job categories believed "if the patient can be distracted from his/her pain, this usually means that they do not have high pain intensity." Focus groups were conducted among several of the different job categories to better understand the basis for these misconceptions. CONCLUSION: The detailed analysis of the survey and focus groups will be provided. This information will be helpful in the creation of educational intervention to improve the quality of pain management patients receive in our system.

Learning Objectives:

1.Participants will be able to distinguish between quatitative and qualitative methods.
• Participants will understand the basis for common misconceptions of providers in pain management.
• Participants will understand the approach necessary in training providers in pain management.

Keywords: Ambulatory Care, Quality Improvement

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.