Pain management in ER may significantly impact patient satisfaction


Hospitals can use patient experience survey responses to target needed improvements, but one common question often concerns clinicians: “Did staff members effectively treat your pain?”

Emergency room patients in particular have high expectations for pain management, according to an article in The New York Times, and when those expectations aren't met, hospital patient satisfaction scores can suffer. In the wake of widespread opioid addiction, health providers are cutting back on prescriptions for such pain medications, despite patient demand. The ED is a particular target for such cutbacks, as many emergency room patients arrive in acute pain.

Patients expect their pain to be treated fully, according to the article, and think prescriptions for medications like opioids are a logical quick fix. And doctors like S. Michael Keller, medical director of the ED at Marion General Hospital in Indiana, says patients react negatively when doctors deny them the painkillers. "I've been swung at, spit on; I've been yelled at, all because I haven't given a patient what they came in demanding," Keller told the newspaper.

Facilities like Marion General are instituting tough opioid prescription guidelines cut the prescribing rate of such drugs, NYT reported. Marion General's program cut the rate of opioid prescriptions in its emergency room by half over the course of 18 months. Shortly thereafter, the hospital’s patient satisfaction scores dropped dramatically. Its emergency room fell from the 58th percentile to the 14th percentile among the 1,100 ERs that use the same survey, according to the article, and its overall satisfaction went from the 61st percentile to the 30th.

But defenders of the current surveys told NYT that Marion General’s case is not reflective of the process as a whole. Recent study data has suggested that hospitals place too much stock in patient satisfaction surveys, FierceHealthcare previously reported, potentially to the detriment of care quality.

Despite the potential negative response from patients, national organizations like the Centers for Disease Control and Prevention have hammered the point that hospitals should use caution to avoid unnecessary opioid prescriptions.

- here’s the NYT article