Joint Commission Releases Statement on Pain Management, Addresses Common Misconceptions

The Joint Commission has issued the following statement on pain management, and addressed common misconceptions regarding related Joint Commission requirements:

In the environment of today’s prescription opioid epidemic, everyone is looking for someone to blame. Often, The Joint Commission’s pain standards take that blame. We are encouraging our critics to look at our exact standards, along with the historical context of our standards, to fully understand what our accredited organizations are required to do with regard to pain.

The Joint Commission first established standards for pain assessment and treatment in 2001 in response to the national outcry about the widespread problem of undertreatment of pain. The Joint Commission’s current standards require that organizations establish policies regarding pain assessment and treatment and conduct educational efforts to ensure compliance. The standards DO NOT require the use of drugs to manage a patient’s pain; and when a drug is appropriate, the standards do not specify which drug should be prescribed.

Our foundational standards are quite simple. They are:

• The hospital educates all licensed independent practitioners on assessing and managing pain.
• The hospital respects the patient’s right to pain management.
• The hospital assesses and manages the patient’s pain.

Requirements for what should be addressed in organizations’ policies include:

HHS Releases National Pain Strategy

The U.S. Department of Health and Human Services (HHS) has issued a National Pain Strategy for improving pain care, identified as “the federal government’s first coordinated plan for reducing the burden of chronic pain…”

Developed by the Interagency Pain Research Coordinating Committee with input from a broad range of experts, and created in response to a 2011 Institute of Medicine (IOM) report ‘Relieving Pain in America:  A Blueprint for Transforming Prevention, Care, Education, and Research,’ the strategy includes recommendations in six areas:

CDC Publishes Final Opioid Prescribing Guidelines for Chronic Pain

The Centers for Disease Control and Prevention (CDC) today finalized its Guideline for Prescribing Opioids for Chronic Pain for primary care physicians prescribing opioids to adults for chronic pain in outpatient settings. The first national standards for prescription painkillers, the guidelines summarize scientific knowledge about the effectiveness and risks of long-term opioid therapy, and provide recommendations for when to initiate or continue opioids for chronic pain; opioid selection, dosage, duration, follow-up and discontinuation; and assessing risk and addressing harms of opioid use. The guidelines do not apply to cancer, palliative or end-of-life care.

According to the CDC, “Improving the way opioids are prescribed through clinical practice guidelines can ensure patients have access to safer, more effective chronic pain treatment while reducing the number of people who misuse, abuse, or overdose from these drugs.”

Publication of the finalized guidelines ends months of debate with the drug industry and pain management physicians which opposed the recommendations during the comment period, arguing they would create unreasonable hurdles for patients who legitimately suffer from chronic pain.

In Touch Issue 2 2015 for The Joint Commission Nursing Care Center Program

The Joint Commission has published the 2nd 2015 issue of In Touch, the newsletter for its Nursing Care Center Program. Contents include:

• Revisions to pain management requirements allow new treatment approaches
• Top five most challenging requirements for nursing care centers in 2014
• FAQs
• Advancing Excellence workshop on disrupting infections in nursing homes
• New on the Web

CDC Looks at Prescription Painkiller Overdoses, Provides Recommendations

The Centers for Disease Control & Prevention (CDC) has published the latest issue of CDC Vital Signs, addresses prescription painkiller overdoses and focusing on the use and abuse of methadone, a synthetic opioid that is often prescribed to manage severe chronic pain due to its long duration of action, powerful effects, and low cost.

Prescription painkiller overdoses were responsible for more than 15,500 deaths in 2009. While all prescription painkillers have contributed to an increase in overdose deaths over the last decade, methadone has played a central role in the epidemic. More than 30% of prescription painkiller deaths involve methadone, even though only 2% of painkiller prescriptions are for this drug. Six times as many people died of methadone overdoses in 2009 than a decade before.

Methadone has been used safely and effectively to treat drug addiction for decades. It has been prescribed increasingly as a painkiller because it is a generic drug that can provide long-lasting pain relief. But as methadone’s use for pain has increased, so has non-medical use of the drug and the number of overdoses. More than 4 million methadone prescriptions were written for pain in 2009, despite the U.S. Food and Drug Administration (FDA) warnings about the risks associated with methadone.

The latest issue of CDC Vital Signs – Prescription Painkiller Overdoses – which looks at the risks posed by methadone and why overdoses have increased, who is at risk, what can be done, the science behind the issue, and provides additional resources, is available on the CDC website at this link.

Latest Joint Commission Speak Up™ Video Highlights Patient Rights

The Joint Commission has released its seventh episode in the animated Speak Up™ video series, “Speak Up:  Know Your Rights.” The new video features the characters Mira, Dr. Pierce, Nurse Amy and Armando as they depict the rights every patient should expect from their care givers. “Speak Up:  Know Your Rights” stresses that everyone has the right to:

• Be informed about the care they will receive;
• Make decisions about their care, including refusing care;
• Have their pain treated;
• Receive information about their care in their own language;
• Be provided with an up-to-date list of their current medications; and
• Be listened to and treated with courtesy and respect.

About The Joint Commission Speak Up™ Video Series:

Produced by The Joint Commission, Speak Up’s entertaining 60-second videos are intended as public service announcements. The series airs on The Joint Commission’s YouTube Channel, as well as other venues, and has received nearly 54,000 views on YouTube alone. This latest Speak Up video provides viewers with tips to help them better understand their rights as a patient. Previous videos in the series, the first of which debuted in March 2011, emphasize the importance of being comfortable speaking up and asking questions about your health care; preventing infection; managing and taking medication safely; preparing for, and what to ask during, doctor’s office appointments; encouraging children to feel confident asking questions about their health; and reducing the risk of falling.

The latest video, “Speak Up:  Know Your Rights,” is embedded below. This video, and the previous six videos in The Joint Commission Speak Up™ Video Series, are also available on The Joint Commission’s YouTube Channel at this link.

The Joint Commission News Release announcing the “Speak Up:  Know Your Rights” video is available at this link. For more information about Joint Commission’s Speak Up™ initiatives, visit the Speak Up™ page on The Joint Commission website.

NQF Endorses Over 160 New Quality Measures in Q1, Q2 2012, Retires 22 Measures

NQF Endorses Prevention Care and Screening Measures

The National Quality Forum (NQF) Board of Directors has endorsed 19 quality measures related to preventive care. The measures – part of NQF’s Population Health: Prevention Endorsement Maintenance project – address a range of clinical preventive care concerns, including influenza and pneumococcal immunizations across a range of healthcare settings, and screenings for specific cancers, sexually transmitted infections, and osteoporosis. Read more at NQF

NQF Endorses Additional Surgical Measures

The National Quality Forum (NQF) Board of Directors has endorsed an additional nine (9) quality measures on surgical care performed in hospitals and in outpatient facilities. The set of measures – part of NQF’s Surgery Endorsement Maintenance, Phase 2 Addendum report – addresses a wide range of surgeries and surgical support processes, including pancreatic resection, cardiac and vascular mortality rates, and antibiotic prophylaxis. The set also includes a new measure evaluating patient experience of care following surgical procedures. Read more at NQF

NQF Endorses All-Cause Unplanned Readmissions Measures

The National Quality Forum (NQF) Board of Directors has endorsed two (2) measures that address all-cause unplanned readmissions in hospitals – an area of healthcare targeted for improvement given national imperatives to make healthcare safer, more affordable, and keep people healthy. Read more at NQF

NQF Endorses Additional Resource Use Measures

The National Quality Forum (NQF) Board of Directors has approved for endorsement four (4)  additional measures on healthcare resource use and costs. The measures – focusing on care costs associated with asthma, chronic obstructive pulmonary disease, hip/knee replacement, and pneumonia – will provide vital data on how resources are used in these areas of care. Such data will help create a more efficient, less wasteful healthcare system. Read more at NQF

NQF Endorses Perinatal Measures

The National Quality Forum (NQF) Board of Directors has approved for endorsement 14 quality measures on perinatal care. The measures address a wide range of care concerns, including childbirth, pregnancy and post-partum care, and newborn care. Read more at NQF

NQF Endorses Renal Measures

The National Quality Forum (NQF) Board of Directors has approved for endorsement 12 quality measures on renal care. The measures address a range of care concerns, for chronic kidney disease, end stage renal disease, and dialysis treatment. Read more at NQF

NQF Endorses Palliative and End-of-Life Care Measures

The National Quality Forum (NQF) Board of Directors has approved for endorsement 14 quality measures on palliative and end-of-life care. The measures address a wide range of care concerns, including pain management, psychosocial needs, care transitions, and experiences of care. Read more at NQF

NQF Endorses Resource Use Measures

The National Quality Forum (NQF) Board of Directors has approved for endorsement four (4) measures on healthcare resource use and costs. The measures – focusing on diabetes and cardiovascular care costs as well as total primary-care costs– will provide vital data on how resources are used in these areas of care. Such data will help create a more efficient, less wasteful healthcare system. Read more at NQF

NQF Endorses Surgical Measures

The National Quality Forum Board of Directors has approved for endorsement 24 quality measures on surgical care performed in hospitals and in outpatient facilities. Read more at NQF

NQF Removes Time-Limited Endorsement for 21 Measures; Measures Now Have Endorsed Status

The National Quality Forum Board of Directors has removed time-limited endorsement status from 21 measures focused on patient safety, surgical care, infectious disease, healthcare systems, and cancer care. Read more at NQF

NQF Endorses Cardiovascular Measures

The National Quality Forum Board of Directors has approved for endorsement 39 measures concerning cardiovascular care. Read more at NQF

NQF Endorses Patient Safety Measures

The National Quality Forum Board of Directors has approved for endorsement four (4) patient safety measures focused on healthcare-associated infections. Read more at NQF

NQF Retires 22 Measures

The National Quality Forum (NQF) Board of Directors has removed 22 measures from the NQF portfolio due to retire requests. The measures cover a range of clinical care concerns, and were declared non-endorsed measures on February 10, 2012. Read more at NQF

More information about The National Quality Forum (NQF) and it’s mission is availble on the NQF website.