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  • Measure Summary
  • NQMC:010984
  • Apr 2008

Pulmonary resection: percentage of patients undergoing pulmonary resection who had treatment implemented with documented reassessment of pain score within 2 hours.

Cassivi SD, Allen MS, Vanderwaerdt GD, Ewoldt LL, Cordes ME, Wigle DA, Nichols FC, Pairolero PC, Deschamps C. Patient-centered quality indicators for pulmonary resection. Ann Thorac Surg. 2008 Sep;86(3):927-32. [40 references] PubMed External Web Site Policy

View the original measure documentation External Web Site Policy

This is the current release of the measure.

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 undergoing pulmonary resection who had treatment implemented with documented reassessment of pain score within 2 hours.

Rationale

More than 30,000 patients undergo pulmonary resection (not including diagnostic lung biopsies) each year in the United States (Memtsoudis et al., 2006). Despite this large number of surgical procedures, there remain to date no standard criteria to measure the quality of care received by patients undergoing pulmonary resection. The general thoracic surgical team developed an a priori set of patient-centered quality of care measures, specific to patients undergoing pulmonary resection.

Adequate pain control remains by far a key component of patients' perception of a successful procedure (Idvall et al., 2002). Frequent assessment of pain with timely treatment and reassessment of pain scores have been identified as process indicators of quality of care in the postoperative period (Idvall, Hamrin, & Unosson, 2002; Meissner, Ullrich, & Zwacka, 2006). Similarly, in a recent Dutch study of quality of lung cancer care, adequate pain control for both operative and nonoperative cases was a proposed measure (Hermens et al., 2006).

Evidence for Rationale

Cassivi SD, Allen MS, Vanderwaerdt GD, Ewoldt LL, Cordes ME, Wigle DA, Nichols FC, Pairolero PC, Deschamps C. Patient-centered quality indicators for pulmonary resection. Ann Thorac Surg. 2008 Sep;86(3):927-32. [40 references] PubMed External Web Site Policy

Hermens RP, Ouwens MM, Vonk-Okhuijsen SY, van der Wel Y, Tjan-Heijnen VC, van den Broek LD, Ho VK, Janssen-Heijnen ML, Groen HJ, Grol RP, Wollersheim HC. Development of quality indicators for diagnosis and treatment of patients with non-small cell lung cancer: a first step toward implementing a multidisciplinary, evidence-based guideline. Lung Cancer. 2006 Oct;54(1):117-24.

Idvall E, Hamrin E, Sjostrom B, Unosson M. Patient and nurse assessment of quality of care in postoperative pain management. Qual Saf Health Care. 2002 Dec;11(4):327-34. PubMed External Web Site Policy

Idvall E, Hamrin E, Unosson M. Development of an instrument to measure strategic and clinical quality indicators in postoperative pain management. J Adv Nurs. 2002 Mar;37(6):532-40. PubMed External Web Site Policy

Meissner W, Ullrich K, Zwacka S. Benchmarking as a tool of continuous quality improvement in postoperative pain management. Eur J Anaesthesiol. 2006 Feb;23(2):142-8. PubMed External Web Site Policy

Memtsoudis SG, Besculides MC, Zellos L, Patil N, Rogers SO. Trends in lung surgery: United States 1988 to 2002. Chest. 2006 Nov;130(5):1462-70. PubMed External Web Site Policy

Primary Health Components

Pulmonary resection; pain treatment; reassessment of pain score

Denominator Description

All patients undergoing pulmonary resection (see the related "Denominator Inclusions/Exclusions" field)

Numerator Description

Treatment implemented with documented reassessment of pain score within 2 hours

Type of Evidence Supporting the Criterion of Quality for the Measure

  • A formal consensus procedure, involving experts in relevant clinical, methodological, public health and organizational sciences
  • 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

Unspecified

State of Use

Current routine use

Current Use

Internal quality improvement

Measurement Setting

Hospital Inpatient

Professionals Involved in Delivery of Health Services

Advanced Practice Nurses

Nurses

Physician Assistants

Physicians

Least Aggregated Level of Services Delivery Addressed

Single Health Care Delivery or Public Health Organizations

Statement of Acceptable Minimum Sample Size

Unspecified

Target Population Age

All ages

Target Population Gender

Either male or female

National Quality Strategy Aim

Better Care

National Quality Strategy Priority

Person- and Family-centered Care
Prevention and Treatment of Leading Causes of Mortality

IOM Care Need

Living with Illness

IOM Domain

Effectiveness

Patient-centeredness

Timeliness

Case Finding Period

January through December

Denominator Sampling Frame

Patients associated with provider

Denominator (Index) Event or Characteristic

Diagnostic Evaluation

Therapeutic Intervention

Denominator Time Window

Does not apply to this measure

Denominator Inclusions/Exclusions

Inclusions
All patients undergoing pulmonary resection

This includes all patients undergoing pneumonectomy, lobectomy, segmentectomy, sleeve resection, and wedge resection, as well as thoracoscopic or open lung biopsy.

Exclusions
Unspecified

Exclusions/Exceptions

Unspecified

Numerator Inclusions/Exclusions

Inclusions
Treatment implemented with documented reassessment of pain score within 2 hours

Exclusions
Unspecified

Numerator Search Strategy

Institutionalization

Data Source

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

Pain treatment and reassessment.

Measure Collection Name

Patient-Centered Quality Indicators for Pulmonary Resection

Submitter

Division of General Thoracic Surgery, Mayo Clinic - Nonprofit Research Organization

Developer

Division of General Thoracic Surgery, Mayo Clinic - Nonprofit Research Organization

Funding Source(s)

Unspecified

Composition of the Group that Developed the Measure

Stephen D. Cassivi, MD, MS; Mark S. Allen, MD; Gregg D. Vanderwaerdt, MPA; Lori L. Ewoldt, RN; Mary E. Cordes, RN; Dennis A. Wigle, MD, PhD; Francis C. Nichols, MD; Peter C. Pairolero, MD; Claude Deschamps, MD

Financial Disclosures/Other Potential Conflicts of Interest

Unspecified

Adaptation

This measure was not adapted from another source.

Date of Most Current Version in NQMC

2008 Apr

Measure Maintenance

Unspecified

Date of Next Anticipated Revision

Unspecified

Measure Status

This is the current release of the measure.

Source(s)

Cassivi SD, Allen MS, Vanderwaerdt GD, Ewoldt LL, Cordes ME, Wigle DA, Nichols FC, Pairolero PC, Deschamps C. Patient-centered quality indicators for pulmonary resection. Ann Thorac Surg. 2008 Sep;86(3):927-32. [40 references] PubMed External Web Site Policy

Measure Availability

Source available from the Annals of Thoracic Surgery Web site External Web Site Policy.

For more information, contact Dr. Stephen Cassivi at the Mayo Clinic, 200 First St. SW, Rochester, MN, 55905; E-mail: cassivi.stephen@mayo.edu.

NQMC Status

This NQMC summary was completed by ECRI Institute on January 10, 2017. The information was not verified by the measure developer.

Copyright Statement

Reprinted from The Annals of Thoracic Surgery, Vol. 86, Issue 3, Cassivi SD, Allen MS, Vanderwaerdt GD, Ewoldt LL, Cordes ME, Wigle DA, Nichols FC, Pairolero PC, Deschamps C, Patient-centered quality indicators for pulmonary resection, 927-33, Copyright (2008), with permission from Elsevier.

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