The Joint Commission has released new pain assessment and management standards that will take effect January 1 for all accredited hospitals.
The new and revised standards come in response to the country’s opioid crisis, which every day claims 91 American lives as a result of overdoses, the Joint Commission said in an announcement.
As part of the national effort to address the opioid epidemic, the accreditor said it would implement those new pain standards and released a report that provides hospitals with its rationale and evidence for the standards.
Among the changes, the new standards will require hospitals to provide nonpharmacological pain treatment methods, alternatives that can include physical methods such as acupuncture and chiropractic therapy, as well as relaxation and cognitive behavioral therapy. It will also require hospitals to facilitate practitioner and pharmacist access to Prescription Drug Monitoring Program databases. Hospitals must also develop a pain treatment plan for patients and monitor patients identified as high risk for adverse outcomes related to opioid treatment.
The Joint Commission came under fire last year from critics who called for changes in the accreditor’s standards, saying they foster dangerous prescribing practices by physicians. Dozens of healthcare organizations, medical experts and consumer advocacy groups sent a letter to the commission saying standards require healthcare organizations to routinely ask all patients to assess their pain and have led to aggressive pain management and the overprescribing of opioids.
The Joint Commission responded in July 2016 by defending the standards and saying detractors have many "misconceptions" about what they actually require of healthcare organizations.
Now just over a year later, the commission answered with its new and revised pain standards in its accreditation manual and said addressing pain assessment and management is “a critical patient safety and quality concern.” In an accompanying report, which includes the rationale behind each requirement, the accreditor said it began a project last year to revise its standards and set up two panels to oversee the process.
The standards will require hospitals to:
- Identify pain assessment and pain management, including safe opioid prescribing, as a priority
- Actively involve the medical staff in leadership roles in organizational performance improvement activities to improve care, treatment and services, as well as patient safety
- Assess and manage patients’ pain and minimize the risks associated with treatment
- Collect, compile and analyze data to monitor performance
President Donald Trump earlier this month said the country’s deadly opioid epidemic was a “national emergency” and promised to file the paperwork to make that official. But so far there has been no official declaration of a national emergency, which would provide states and federal agencies with more resources and power to combat the opioid problem, and a White House spokesman said last week the paperwork was going through an expedited legal review.
Last year, the Centers for Disease Control and Prevention issued guidelines advising doctors to prescribe treatments other than opioids for chronic pain outside of active cancer treatment, palliative care and end-of-life care.