Evaluation of the Performance Improvement CME Paradigm for Pain Management in the Long-Term Care Setting

Perry G. Fine, David H. Bradshaw, Mitchell J. Cohen, Stephen R. Connor, Gary Donaldson, Christopher Gharibo, Barry E. Gidal, James Cameron Muir, Helen N. Tselentis

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Objective: A performance improvement continuing medical education (PI CME) activity was designed to assist clinicians with accurately identifying and appropriately managing persistent pain in long-term care facility (LTCF) residents. Design: Volunteer LTCFs participated in a three-stage PI CME model consisting of: 1) baseline assessment, 2) implementation of practice improvement interventions, and 3) reassessment. Expert faculty chose performance measures and interventions for the activity. A champion was designated ateach LTCF to collect resident charts and enter data into an online database. Setting: Eight LTCFs located across the United States participated in the activity. Patients: Fifty resident charts were randomly selected by each LTCF champion (25 for stage 1 and 25 for stage 3); a total of 350 charts were reviewed. Interventions: In addition to a toolkit containing numerous performance improvement resources, an in-service meeting led by an expert faculty member was conducted at each LTCF. Outcome Measures: Stage 3 data were collected 6 weeks after implementation of interventions and compared with stage 1 baseline data to measure change in performance. Results: Aggregate data collected from seven LTCFs completing the PI CME activity through stage 3 revealed improvements from baseline in four of five performance measures. Conclusions: This CME activity allowed for collection of data demonstrating performance improvement in persistent pain management. The tools used as part of the intervention (available at http://www.achlpicme.org/LTC/toolkit) may help other clinicians enhance their management of LTCF residents with persistent pain.

Original languageEnglish (US)
Pages (from-to)403-409
Number of pages7
JournalPain Medicine (United States)
Issue number3
StatePublished - Mar 2014


  • Geriatrics
  • Long-Term Care
  • Pain Management
  • Performance Improvement

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine


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