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Hospital pain control factors assessed
- 1. Pain well controlled during hospital stay
- 2. Full Factorial Two Level Three Factors Pain Score in room on white board MedicationTime Documented-Last Pain Med & next time can take Patient’s pain level assessed during rounding Two replicates Blocks –by unit (2)
- 3. Estimated Effects and Coefficients for Score with Pt. Navigator (coded units) Term Effect Coef SE Coef T P Constant 3.1875 0.06250 51.00 0.000 Block -0.0625 0.06250 -1.00 0.351 Pain Score documented 0.6250 0.3125 0.06250 5.00 0.002 Med time documented 0.8750 0.4375 0.06250 7.00 0.000 Rounds Pain Assessment 2.3750 1.1875 0.06250 19.00 0.000 Pain Score documented* 0.1250 0.0625 0.06250 1.00 0.351 Med time documented Pain Score documented* -0.3750 -0.1875 0.06250 -3.00 0.020 Rounds Pain Assessment Med time documented* -0.1250 -0.0625 0.06250 -1.00 0.351 Rounds Pain Assessment Pain Score documented* 0.1250 0.0625 0.06250 1.00 0.351 Med time documented* Rounds Pain Assessment S = 0.25 PRESS = 2.28571 R-Sq = 98.46% R-Sq(pred) = 91.96% R-Sq(adj) = 96.70%
- 5. Only the significant factors
- 10. Did see the three factors have an significant impact on our patient’s perception of pain well controlled during their stay The most significant impact is the pain assessment during rounding Limitations – the residuals results – On a larger scale all our discharged patients receive the NRC Picker survey. We will monitor results over time for this question as we ensure compliance to standard practices from the results of this DOE.
Editor's Notes
- The patient satisfaction survey question, “Pain was well controlled during your hospital stay”, has been an area that our clinical staff have tried to improve upon. They have put into place new initiatives, but have not determined the most effective practice to improve this score and sustain performance. This DOE will help identify if the initiatives improve patient’s feeling of their pain being well controlled and what action has the most significant impact for improving our scores. Patient’s on the Ortho and Surgical units were selected for this study. Each patient was asked at discharge by our patient navigator how they would rate how well their pain was controlled on a scale of 1 to 5, one being the lowest possible score and 5 being the highest. This interview was completed off the floor as the patient was escorted to their family vehicle. Patients on these units were randomly selected for each of the categories by their D numbers.
- Interpretations: The block (2 different units) is not significant with a p value of 0.351. The unit results do not differ significantly. All three factors have significant impact on the question of pain well controlled during stay. The only interaction that is significant is the two interaction of pain score documented and rounds pain assessment. High R squared value
- Histogram – provides a nice visual of the results from the most significant factor, in descending order. The pain assessment during rounds has the most significant impact, at the 0.05 level; all three factors alone have a significant impact along with the interaction between A and B.
- In the reduced model, A, B, C and AB demonstrate significance at the 5% level, with pain assessment during rounding being the most significant factor.
- 1.Normal probability Plot – the residuals follow the diagonal line, however they are in grouped. 2. Residuals vs. fit plot- they are scattered, however in a non random fashion for the most part 3. Histogram of the residual 4. Residuals vs. order demonstrates randomness over the line, with the exception of observations 14,15, and 16. We had two observations with unusual observations denoted in our results.