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EU-Wide Initiatives: Pain out Report - postoperative pain

Executive Summary:

Post-operative pain is an inevitable consequence of surgery. Poorly managed post-operative pain causes suffering, increases costs of care and can lead to disabling chronic pain. Despite the availability of high-quality guidelines and advanced pain management techniques acute postoperative pain management is still far from being satisfactory. About 40% of patients worldwide report inadequate pain relief despite receiving treatment.

PAIN OUT is a comprehensive, concerted European effort to develop effective, evidence-based approaches to improve care of pain in patients after surgery. Launched in January 2009, with four-year funding from the European Union's (EU) 7th Framework Program, it integrates experience gained from a national initiative in Germany (QUIPS, a national acute pain database) and the expertise of world-leading, European-based groups dealing with benchmarking, health outcomes and health care utilization research. PAIN OUT has created a large, international Acute Pain Registry as a platform for research and quality improvement. A network of participating hospitals contributes data to the registry and receives web-based feedback and benchmarking of their quality of care, in return. In parallel, the registry allows analysis of the large data bank as well as additional prospective data collections by using the existing infrastructure and network of PAIN OUT hospitals.

The main objective of the PAIN OUT project was to develop and to validate a system for measurement and feedback of outcome quality and support of decision making. Therefore, a core data set to be collected in all participating sites was defined using a Delphi consenting process. Project implementation in the 11 national clinical consortium sites (NCCS) included translation of questionnaires according to the standard procedures of translation and back-translation and training of staff for data collection. Online web-based data input facilities are fully established. The central data base was established successfully and contains more than 35,000 patient cases by now. A web-based software system has been developed, allowing for internal and external benchmarking of patient outcome data and offering users continuous feedback and analyses of their quality of care. By evaluating their results, users are able to implement change management concepts and can provide their patients with better care.