‘Pain Free’ After Surgery Is New Goal at More Hospitals
Interesting article from Berlin in the Wall Street Journal:
“German hospitals, dogged by a cultural grin-and-bear-it attitude toward pain, are starting to change.
About 120 hospitals in the country now carry “pain-free” certifications—essentially a pledge to keep patients’ pain at bearable levels. Meanwhile, 170 German hospitals are participating in a multinational registry known as Pain Out to swap information on patients’ satisfaction with their pain control, in effect drawing a map of pain management in the country and highlighting particularly effective approaches.
New research is helping to change attitudes. There is a growing appreciation that poor pain control in the days following surgery can prolong hospital stays or cause acute pain to become chronic. German doctors also are responding to studies showing that small operations can generate intense pain. And hospitals are feeling pressure to compete for a younger crop of patients expecting better pain control.“
It’s been a long (long) time since I studied and worked as an in-patient physiotherapist in Australian hospitals, but I recall Patient Controlled Anaesthesia being widely used after a majority of surgical procedures requiring a stay, with the theory that effective control of acute pain could help prevent chronic pain (nobody explained why or how, but I don’t think many people really knew back then).
It would be interesting to know if the German example is an outlier – calling international readers!
A little gem to finish off the article:
“At Bethel Hospital, doctors say improving how they treat pain helped the hospital attract a larger share of Germany’s growing demand for hip and knee replacements. The small hospital in a neighborhood of former West Berlin tripled its volume of orthopedic surgeries over the past six years, said Dr. Rüdiger Haase, the chief orthopedic surgeon. Bethel, which obtained an acute-pain-management certification in 2006, introduced local anesthetic techniques following surgery and instituted protocols to require staff to routinely assess pain. As a result, patients stabilized and regained their mobility faster, Dr. Haase said.”
…tripled its volume…
If I had to have a TKR or THR in Germany, I think I’d be looking for a hospital where staff asked me about pain and offered analgesia too.
A “No Pain” approach is a great start, wouldn’t it be great to see hospitals adopt a “Know Pain” attitude as well!
– Tim Cocks
There’s certainly some room to improve in hospital land when it comes to pain education. It seems in the (neuro)musculoskeletal sphere it is largely accepted that explaining pain should form part of the treatment package. I think we have a way to go in getting our other allied health, nursing and medical staff to come on board with the bio psychosocial aspects of pain management. My first experiences attempting to assist patients to mobilise day one post op were often unsuccessful, or at least short lived (no sooner had i triumphantly left the bedside to write notes, the patient had recruited the nurse to assist them back into bed). Now I find that a short but not -too-dumbed down explanation of why they have pain and what they can do to control it (rather than eliminate it) goes a long way to getting them onside.
The article reminds me of my own recent experience led by vanity. I’m not aging too badly and vanity led me to have a surgical procedure on the veins of my left lower leg. My surgeon, without any attempt to enquire into any past “Pain” experiences assured me that the procedure needed only local anaesthesia and was, basically pain free…….I should have known better………The experience was horrendous, much to the surprise of the surgeon in question……..My “Pain Lecture” went right over his head. In his eyes I’m just a wimp…….I’ve suffered persistant pain in that leg for over twenty years!!!!!! You can work out the rest………
Nice to hear about this. It may be worth rereading “surgical sadness”