Innovations in End-of-Life Care
an international journal of leaders in end-of-life care

• facility administrators' buy-in
• regulators' buy-in
• resident and family buy-in
• pain management quality improvement process in place (8)
• explicit facility plan for assessing resident/family satisfaction (7)
• pain management included in facility's mission, patient bill of rights and other documents
• recruiting influential allies
  
  
  
  

• facility needs assessment
• interdisciplinary pain management team (6)
• context-sensitive action plan
• standardized tool for cognitively intact residents (1)
• standardized tool for cognitively impaired residents (2)
• standardized facility pain scale (3)
• standardized pain documentation flow sheet (4)
• explicit pain assessment/management policies (5)
• pain management quality improvement process in place (8)

Technical

Cultural

• assessing discrepancy between current and recommended practice (e.g., knowledge surveys, needs assessments)
• education plan for facility RNs (10)
• education plan for facility LPNs (11)
• education plan for facility nurse assistants (12)
• education plan for facility rehab staff (13)
• education plan for all new facility staff (14)
• explicit education program for residents and families (9)
  
  

• coaching/mentoring of participants
• staff empowerment
• decreased staff frustration
• improved nurse-physician communication and conflict negotiation regarding pain management
• improved team work
• creating a culture of advocacy
• identifying one or more institutional pain management champions
• celebrating accomplishments shared with program participants (e.g., testimonials, internal and external publications and presentations, posters)