Quality assurance for interventional pain management procedures.

BACKGROUND Over the last decade various guidelines for quality assurance in pain medicine have been published for cancer pain, acute postoperative pain and other pain conditions. However, quality assurance for interventional pain management procedures has yet to be addressed. An interventional pain program should at least evaluate 1) efficacy of pain relief; 2) complication rate; and 3) patient satisfaction. OBJECTIVE This study was designed to monitor the quality of interventional pain management procedures in a university teaching hospital. STUDY DESIGN A prospective survey. METHODS From January 1, 2004, to June 30, 2004, the quality of interventional pain management procedures in a university teaching hospital in Miami, Florida was monitored. Questionnaires assessing immediate pain relief, patient satisfaction, and complications were provided to each patient and physician immediately after completion of each procedure. Data was collected before patients were discharged. RESULTS A total of 566 patients with a mean age of 52.9 years participated in the survey. Interventional pain management procedures included epidural steroid injections, facet joint blocks, transforaminal epidural injections, sympathetic nerve blocks, lumbar discography, nucleoplasty, percutaneous disc decompression, spinal cord stimulator trial, and intravenous regional blocks, etc. Among 528 patients who reported their pain scores before and after procedures, 487 (92%) patients reported various degrees of pain relief immediately following their procedures. The average pain score decreased 4.7 on a o to 10 scale after treatment (p < 0.001). No major complications were reported for this group of patients. Among 442 patients who answered the question regarding satisfaction, 406 (91.8%) were satisfied, or highly satisfied, with the immediate outcome of their procedures. CONCLUSION The results of the current study indicate that quality assurance of interventional pain management procedures in terms of immediate pain relief following the procedure, low complication rate, and high patient satisfaction can be achieved through application of a quality assurance program.