Cut Door to Pain Medication  Time in the ED

"The top three things patients want in an Emergency Department are for staff to care about them, to be informed about delays, and pain control," explains Studer Group Coach Julie Kennedy. "We have to hold up the mirror and ask ourselves how well we really do at meeting these expectations, even when we are afraid of finding out."

One of the first steps to show patients we care is to have an excellent pain management standard in place. You can also capture baseline data to measure door to pain management time (the amount of elapsed time between when the patient enters the ED and when they are offered pain medication) through a random audit of patient charts. "When we see that a patient with kidney stones sat in our ED for 80 minutes before we offered them pain medication, it's not acceptable," adds Kennedy. "But we need to know how we are currently doing before we can improve our response times."

What's an acceptable door to pain management time? Studer Group recommends 30 minutes as a goal, but has coached a number of Emergency Departments who routinely deliver in 12 to 18 minutes. (They changed their processes and use pain protocols.)

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Once an organization can quantify its opportunity for improvement, the next step is to hardwire the consistent use of effective triage pain management protocols.

But what about the patients who use the ED inappropriately (i.e. "drug seekers")? "I find that many EDs have an elevated view of how many drug seekers they see,” says Kennedy. "I recommend taking a look at the percentage of patients that don't truly need daily pain management. This helps us check our perception against the data to better understand the extent of the problem."