Enhancing pain assessment in pediatric sickle cell disease by applying quality improvement science

• Type of Material: Article
• Authors: Soumitri Sil, Emory University; Alana Goldstein-Leever, Children's Healthcare of Atlanta; Curtis Travers, Emory University; Jordan Marchak, Emory University; Ashley Alexander, Children's Healthcare of Atlanta; Beth Thompson, Children's Healthcare of Atlanta; Anya Griffin, Emory University; Courtney McCracken, Emory University; Tamara New, Emory University
• Language: English
• Date: 2019-12-01
• Publisher: American Psychological Association
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2019 American Psychological Association.
• Final Published Version (URL): http://dx.doi.org/10.1037/cpp0000277
• Title of Journal or Parent Work: Clinical Practice in Pediatric Psychology
• ISSN: 2169-4826
• Volume: 7
• Issue: 4
• Start Page: 335
• End Page: 346
• Grant/Funding Information: None declared.
• Keywords: sickle cell disease; hospitalization; functional ability; pain assessment; quality improvement
• Research Categories: Health Sciences, Health Care Management; Health Sciences, Medicine and Surgery

Abstract

Objective: Standardized pain assessment and interventions are recommended for youth hospitalized for pain. This quality improvement project integrated into a pediatric psychology service aimed to increase the standardized assessment of pain-related functional ability for youth with sickle cell disease (SCD) hospitalized for pain. Method: Children and adolescents (n = 102) with SCD referred for psychology consultation for poor coping in response to pain during hospitalization completed a validated self-report of functional ability in addition to pain intensity during inpatient psychology visits. At the time of the quality initiative, routine and standardized assessment of pain-related functional ability was not integrated into standard clinical care. Plan-do-study-act cycles determined the feasibility and addressed common barriers of routine assessment and documentation of pain-related functional ability among youth with SCD during inpatient psychology visits with the primary goal to increase assessment of functional ability to at least 85% among patients with SCD referred for pediatric psychology consultation to address pain management within 1 year. Results: Through iterative plan-do-study-act cycles, routine assessment of pain-related functional ability during psychology visits increased to an average of 93% over the course of 12 months. Routine, standardized assessment of functional ability was considered feasible within a pediatric psychology service. Conclusions/Lessons Learned: This project supported the feasibility of integrating standardized assessment of functional ability to enhance pain assessment for youth hospitalized for SCD pain as part of routine clinical care in a multidisciplinary setting regardless of psychology referral.