May 28, 1999

Recently the MGH had its pulse taken — its pain pulse — to measure simultaneously the pain level of all inpatients and assess pain management practices at the hospital.

During the test, clinical staff asked their patients questions about the pain they were feeling and how that pain had affected their ability to enjoy life in the past 24 hours. Patients rated these levels on a scale of 1 to 10, the former representing no pain and the latter representing the most severe pain imaginable.

"Test results show we are doing a pretty good job in monitoring pain," says Heather Young, RN, of Palliative Care and the Pain Service, who coordinated the assessment, "but we have areas where we need to make improvements."

Reporting on the pain that affected their ability to enjoy life in the past day, 42 percent of patients said they had experienced a pain level of 5 and above, and 22 percent said they had a pain level of 8 and above. According to Young, any rating above a 5 means a significant amount of pain, indicating a need for additional interventions and better pain management practices throughout the hospital.

The pain pulse assessment, which will be administered annually, is part of the MGH Cares About Pain Relief campaign, a 2 ½-year program recently initiated by the MGH Pain Service, Palliative Care and Patient Care Services to make pain relief a hospitalwide priority. The program will evaluate pain management practices, examine clinician knowledge and attitudes about pain relief, educate staff about managing pain and develop interventions to target areas in which knowledge may be deficient.

The information collected from this year's pain pulse will serve as a baseline for measuring improvements in pain levels as programs are implemented. Educational discussions about basic pain management and pharmacology have already begun on the pilot floors, White 10, Ellison 12 and 7.

"The pain pulse helped raise some real awareness among clinicians about the importance of assessing pain," says Young.

The MGH Cares about Pain Relief campaign is supported by the Mayday Foundation, a global organization dedicated to pain management. The campaign aims to establish guidelines that may be used at the MGH as well as applied at other medical centers.