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  • Measure Summary
  • NQMC:009593
  • Feb 2014

Pain management: percentage of patients with documentation showing that the practitioner performed laboratory, radiologic, and other diagnostic tests as appropriate.

American Medical Directors Association (AMDA). Implementing AMDA's clinical practice guidelines in the long term care setting -- CPG implementation series: pain management manual. Columbia (MD): American Medical Directors Association; 2014. 113 p.

This is the current release of the measure.

The measure developer reaffirmed the currency of this measure in April 2016.

Primary Measure Domain

Clinical Quality Measures: Process

Secondary Measure Domain

Does not apply to this measure

Description

This measure is used to assess the percentage of patients with documentation showing that the practitioner performed laboratory, radiologic, and other diagnostic tests as appropriate.

Rationale

Pain is common in the long term care (LTC) setting, and it affects measures of patients' well-being, such as mood and the ability to perform activities of daily living. Pain management should be considered a patient's right in the LTC setting. Practitioners have a professional obligation to prevent needless suffering and to do their best to provide effective pain relief (American Geriatrics Society, 2009). Accordingly, a systems approach is needed to recognize, asses, treat, and monitor pain in the LTC setting.

Appropriate diagnostic testing based on the patient's existing diagnoses and/or conditions, history and physical, and pain location in addition to information from the patient's family will assist the practitioner in ordering the appropriate pain treatment.

Evidence for Rationale

American Geriatrics Society Panel on Pharmacological Management of Persistent Pain in Older Persons. Pharmacological management of persistent pain in older persons. J Am Geriatr Soc. 2009 Aug;57(8):1331-46. PubMed External Web Site Policy

American Medical Directors Association (AMDA). National Quality Measures Clearinghouse (NQMC) measure submission form: geriatrics: percentage of patients with documentation showing that the practitioner performed laboratory, radiologic and other diagnostic tests as appropriate. 2014 Feb.  7 p.

American Medical Directors Association (AMDA). Pain management in the long term care setting. Columbia (MD): American Medical Directors Association (AMDA); 2012. 60 p. [93 references]

Kaasalainen S. An action-based approach to improving pain management in long term care. J Am Med Dir Assoc. 2010 Mar;11(3):B3.

Nursing standard of practice protocol: pain management in older adults. In: Horgas AL, Yoon SL, Grall M. Boltz M, Capezuti E, Fulmer TT, Zwicker D, O'Meara A, editor(s). Evidence-based geriatric nursing protocols for best practice, 4th edition. New York (NY): Springer Publishing Company; 2011 Nov.

Primary Health Components

Long term care (LTC); pain management; diagnostic testing; elderly

Denominator Description

Number of all patients with reported pain aged greater than or equal to 65 years

Numerator Description

Number of patients with documentation showing the practitioner performed laboratory, radiologic and other diagnostic tests as appropriate (see the related "Numerator Inclusions/Exclusions" field)

Type of Evidence Supporting the Criterion of Quality for the Measure

  • A clinical practice guideline or other peer-reviewed synthesis of the clinical research evidence
  • One or more research studies published in a National Library of Medicine (NLM) indexed, peer-reviewed journal

Additional Information Supporting Need for the Measure

Unspecified

Extent of Measure Testing

The measure has been developed by the national organization American Medical Directors Association (AMDA) and promotes precise development and the use of clinical performance measures.

Evidence for Extent of Measure Testing

American Medical Directors Association (AMDA). National Quality Measures Clearinghouse (NQMC) measure submission form: geriatrics: percentage of patients with documentation showing that the practitioner performed laboratory, radiologic and other diagnostic tests as appropriate. 2014 Feb.  7 p.

State of Use

Current routine use

Current Use

Internal quality improvement

Measurement Setting

Assisted Living Facilities

Skilled Nursing Facilities/Nursing Homes

Professionals Involved in Delivery of Health Services

Advanced Practice Nurses

Physician Assistants

Physicians

Least Aggregated Level of Services Delivery Addressed

Individual Clinicians or Public Health Professionals

Statement of Acceptable Minimum Sample Size

Unspecified

Target Population Age

Age greater than or equal to 65 years

Target Population Gender

Either male or female

National Quality Strategy Aim

Better Care

National Quality Strategy Priority

Prevention and Treatment of Leading Causes of Mortality

IOM Care Need

End of Life Care

Getting Better

Living with Illness

IOM Domain

Effectiveness

Case Finding Period

Unspecified

Denominator Sampling Frame

Patients associated with provider

Denominator (Index) Event or Characteristic

Clinical Condition

Institutionalization

Patient/Individual (Consumer) Characteristic

Denominator Time Window

Does not apply to this measure

Denominator Inclusions/Exclusions

Inclusions
Number of all patients with reported pain aged greater than or equal to 65 years

Exclusions
Unspecified

Exclusions/Exceptions

Unspecified

Numerator Inclusions/Exclusions

Inclusions
Number of patients with documentation showing the practitioner performed laboratory, radiologic and other diagnostic tests as appropriate

Note: "Documentation" refers to written evidence as to whether a procedure/discussion was indicated/done or not indicated/not done.

Exclusions
Unspecified

Numerator Search Strategy

Institutionalization

Data Source

Administrative clinical data

Electronic health/medical record

Paper medical record

Type of Health State

Does not apply to this measure

Instruments Used and/or Associated with the Measure

Unspecified

Measure Specifies Disaggregation

Does not apply to this measure

Scoring

Rate/Proportion

Interpretation of Score

Desired value is a higher score

Allowance for Patient or Population Factors

Unspecified

Standard of Comparison

Internal time comparison

Original Title

Percentage of patients with documentation showing that the practitioner performed laboratory, radiologic, and other diagnostic tests as appropriate.

Measure Collection Name

Pain Management

Measure Set Name

Clinical Process Measures

Measure Subset Name

Assessment

Submitter

American Medical Directors Association - Nonprofit Organization

Developer

American Medical Directors Association - Nonprofit Organization

Funding Source(s)

Unspecified

Composition of the Group that Developed the Measure

  • Karl Steinberg, MD, CMD, Chair
  • Nancy Losben, RPH, CCP, FASCP, Co-Chair
  • Charles Cefalu, MD, MS, Project Chair
  • Hosam Kamel, MD, CMC, Project Vice-Chair
  • Debra Bakerjian, PhD, RN, FNP
  • Norda Bellantoni, RN, CNHA, CAS,CALA, FACHCA
  • Annette Carron, MD
  • Debra Choma, RN
  • Guy Crosson, CHNA, PHR
  • Ronald Fisher, MD, CMD
  • Raza Haque, MD
  • Kim House, MD, CMD
  • Renante Ignacio, MD, CMD
  • Kevin W. O'Neil, MD, FACP, CMD
  • Sue Pearson, DO, PhD, CMD
  • Frederick Rowland, MD, CMD
  • Keerti Sharma, MD
  • Cathy Tracey, MS, RN, CRRN
  • Christopher Unrein, DO, FACP, CMD
  • Brinder Vij, MD
  • Jacqueline Vance, RNC, BSN, CDONA/LTC, Facilitator
  • Mary M. Mulligan, RN, BSN, MA, CDONA/LTC, Facilitator

Financial Disclosures/Other Potential Conflicts of Interest

Faculty and workgroup members do not have any financial relationships to disclose.

Adaptation

This measure was not adapted from another source.

Date of Most Current Version in NQMC

2014 Feb

Measure Maintenance

Unspecified

Date of Next Anticipated Revision

Unspecified

Measure Status

This is the current release of the measure.

The measure developer reaffirmed the currency of this measure in April 2016.

Source(s)

American Medical Directors Association (AMDA). Implementing AMDA's clinical practice guidelines in the long term care setting -- CPG implementation series: pain management manual. Columbia (MD): American Medical Directors Association; 2014. 113 p.

Measure Availability

Source available for purchase from the American Medical Directors Association (AMDA) Web site External Web Site Policy.

For more information, contact AMDA at 11000 Broken Land Parkway, Suite 400, Columbia, MD 21044; Phone: 410-740-9743; Fax: 410-740-4572; E-mail: info@paltc.org; Web site: www.paltc.org External Web Site Policy.

Companion Documents

The following is available:

  • American Medical Directors Association (AMDA). National Quality Measures Clearinghouse (NQMC) measure submission form: geriatrics: percentage of patients with documentation showing that the practitioner performed laboratory, radiologic, and other diagnostic tests as appropriate. 2014 Feb. 7 p.

For more information, contact AMDA at 11000 Broken Land Parkway, Suite 400, Columbia, MD 21044; Phone: 410-740-9743; Fax: 410-740-4572; E-mail: info@paltc.org; Web site: www.paltc.org External Web Site Policy.

NQMC Status

This NQMC summary was updated by ECRI Institute on September 23, 2014. The information was verified by the measure developer on November 20, 2014.

The information was reaffirmed by the measure developer on April 5, 2016.

Copyright Statement

This NQMC summary is based on the original measure, which is subject to the measure developer's copyright restrictions.

Reprint/reproduction permission must be requested from the American Medical Directors Association (AMDA).

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