Évaluation à court et à moyen terme d'une démarche qualité pour la prise en charge de la douleur postopératoire dans un CHU

Objectives. - Evaluation of the short- and medium-term impact of a postoperative pain management quality assurance programme in a university hospital. Study design. - Prospective study. Materials and methods. - In 1998: chart review and survey of patients and professionals. Principal corrective actions: support for evaluation and tracking of potentially painful surgical procedures, prescription form including an emergency treatment plan, distribution of a set of guidelines. Evaluation was identical during the quality assurance programme and three years later, in 2003. Results. - In 2003, information regarding postoperative analgesia was received by 70% of patients and understood by 99% (50% in 1998, p < 0.001). Sixty-two percent of patients were totally satisfied with their doctors in 2003 vs 75% in 1998 (NS). Pain was documented in 63.1% of charts in 2003, vs 10% in 1998 (p < 0.001). Hundred percent of doctors were aware of the analgesic protocols in 2003 vs 69% in 1998 (p < 0.02). In 2003, the treatment of analgesic side effects was known by 86% of doctors vs 29% in 1998 and these effects were looked for by 57% of caregivers in 2003 vs I I% in 1998 (p < 0.001). Conclusion. - Management of postoperative pain has progress significantly and the quality indicators used for evaluation have improved. Patients are better informed, which raises standards. The programme will be extended to all other surgical departments of the hospital, under the authority of CLUDS (Committee for Pain Control and Palliative Care).