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Improvement Plan Tool Kit

Your Name

School of Nursing and Health Sciences, Capella University

NURS-FPX4020: Improving Quality of Care and Patient Safety

Instructor Name

Month, Year
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Improvement Plan Tool Kit

Pain under-treatment or management continues to be a significant patient safety concern

in healthcare facilities affecting quality of care and patients’ outcomes. This assessment offers a

list of resources that can be used by healthcare professionals to enhance and maintain the best

practices of pain management. The curated collection of 12 annotated professional and scholarly

resources is organized around four key themes: methods for translating evidence-based pain

management protocols into practice, ways of effective collaboration and communication among

team members, technologies for pain assessment and tracking, and patient-centered approaches

to pain knowledge and management. This toolkit is designed to provide healthcare professionals

with evidence-based guidance, resources, and best practices for improving pain assessment,

communication, technology integration, and patient involvement. The resources have been

chosen to overcome the most frequent obstacles to pain management and to reflect the modern

trends in patient-centered approach.

Strategies for Implementing and Sustaining Evidence-Based Pain Management Practices in

Healthcare Settings

Pereira, V. C., Silva, S. N., Carvalho, V. K. S., Zanghelini, F., & Barreto, J. O. M. (2022).

Strategies for the implementation of clinical practice guidelines in public health: an

overview of systematic reviews. Health Research Policy and Systems, 20(1).

https://doi.org/10.1186/s12961-022-00815-4

The systematic review of strategies for implementing clinical practice guidelines in

public health settings provides useful information for the healthcare professionals who

are to enhance the pain management practices. Although the study is not particularly

targeted at pain, the results are still very applicable and can be easily applied to pain
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management programs. The resource is especially helpful for the interprofessional teams

involved in the implementation of evidence-based pain management practices since it

offers a broad overview of the best practices for implementation. In this way, it assists the

teams in identifying the most suitable approaches for their particular healthcare

environment, which may decrease the chances of suboptimal pain management because

of non-compliance with guidelines. The value of this resource is in the fact that it helps to

fill the gap between the guideline development and the implementation of the guidelines

which is the key to the enhancement of the patient care. This toolkit would be most useful

to healthcare administrators, quality improvement specialists, and clinical leaders who are

involved in the planning of implementation of new pain management practices. It could

be particularly useful in cases where the facilities are experiencing low compliance to

pain management standards or when implementing new best practices. In this way, this

resource may be useful for healthcare teams to understand what strategies can be

employed to overcome the barriers to change and foster the implementation of the best

practices in pain management.

Salamon, K. S., Russell, C., DeVinney, D., & Soprano, C. M. (2024). Quality Improvement

Protocol: Improving the Use of Nonpharmacological Pain Management Strategies within

the Inpatient Hospital Setting. Journal of Clinical Medicine, 13(6), 1680–1680.

https://doi.org/10.3390/jcm13061680

This quality improvement protocol of nonpharmacological pain management strategies

for inpatient care is an especially timely and valuable tool for clinicians interested in

improving pain management. Its strength is in the way it presents a pragmatic model for

change, including the fact that education is not enough to bring about major change. The
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fact that a best practice alert in the electronic medical record increased

nonpharmacological pain management services ordered by 50% is information that the

study’s team needs to share with other teams working on such projects. This resource is

especially valuable for nursing staff, pain management specialists, and quality

improvement teams as it offers a clear case of how organizational changes can

significantly enhance the application of pain management interventions. It tackles the

high risk of patient safety concern of undertreatment of pain through the advocacy of a

more holistic approach to pain management that does not rely solely on medications. The

toolkit derived from this resource would be most useful where healthcare organisations

are seeking to expand the range of pain management strategies or where there is a need to

enhance the application of non-pharmacological methods. It provides effective solutions

to the challenges of implementation including low awareness or challenges with the

referral process, which makes it a useful resource for any healthcare worker

implementing change in pain management.

Chen, M.-C., Yeh, T.-F., Wu, C.-C., Wang, Y.-R., Wu, C.-L., Chen, R., & Shen, C.-H. (2023).

Three-year hospital-wide pain management system implementation at a tertiary medical

center: Pain prevalence analysis. PLOS ONE, 18(4), e0283520.

https://doi.org/10.1371/journal.pone.0283520

The findings of this three-year study on the hospital-wide pain management system

implementation are highly beneficial for healthcare professionals who want to develop

sustainable changes in pain management. The resource is most beneficial for hospital

administrators, quality improvement teams, and clinical leaders that are charged with the

responsibility of designing and implementing pain management plans for entire health
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care organizations. Its strength is that it shows how comprehensive approach can be used

in order to apply standard procedures, educate people, use monitoring systems and

perform regular audits. The fact that the overall pain incidence has declined substantially

over the study period, particularly among postoperative patients, suggests that such

multifaceted approaches can effectively mitigate the high patient safety concern of

inadequate analgesia. This resource will be most useful for hospitals that are interested in

the idea of a ‘pain-free hospital’ or those who are planning a major change in their pain

management processes. It provides a blueprint for change, stressing that change should be

made based on evidence, with medical professionals’ input and with technology for

tracking and reporting. The toolkit derived from this study would be most useful where a

facility is experiencing high levels of reported pain among patients or where there is a

desire to enhance the general performance on pain management. Thus, the paper provides

a rich description of a long-term implementation success story that may be useful for

other healthcare settings and serves as a practical guide for any team that is interested in

enhancing pain management practices.

Interdisciplinary Collaboration and Communication Techniques to Enhance Pain

Assessment and Treatment

Connell, N., Pallavi Prathivadi, Lorenz, K. A., Zupanc, S. N., Singer, S. J., Krebs, E. E., Yano, E.

M., Wong Connie C, & Giannitrapani, K. F. (2022). Teaming in Interdisciplinary Chronic

Pain Management Interventions in Primary Care: a Systematic Review of Randomized

Controlled Trials. Journal of General Internal Medicine, 37(6), 1501–1512.

https://doi.org/10.1007/s11606-021-07255-w
 6

This systematic review of teaming in interdisciplinary chronic pain management

interventions in primary care settings is a useful guide for clinicians who want to enhance

the quality of chronic pain management. It is most helpful for primary care physicians,

pain specialists, and healthcare managers and directors who are charged with the

responsibility of overseeing changes in quality and safety in pain management. The focus

of the study on bounded teams and dynamic teaming gives a holistic view of how

interdisciplinary collaboration can be applied in different healthcare settings. This

resource provides helpful information about the ways to minimize the likelihood of poor

pain management by comparing the efficiency of various team configurations and

activities. Its emphasis on primary care is particularly useful for dealing with the issues of

chronic pain in a setting where most of the pain consultations take place. This resource

can be helpful for healthcare professionals to create better interdisciplinary pain

management programs, to increase the collaboration between different specialists, and to

increase the quality of the treatment for the patients. The toolkit derived from this study

would be most useful in contexts where healthcare organisations are seeking to develop

or enhance interdisciplinary approaches to pain management, particularly in primary care

contexts. It can help in the creation of the dynamic and adaptive teams that can respond

to the multifaceted and constantly changing nature of chronic pain, which can in turn lead

to the improved pain management.

Glassburn, S., Delbridge, E., Loghmani, M. T., Newton, A. D., Binion, K., Romito, L., & Willis,

D. R. (2022). Communication tools and strategies for interprofessional teamwork in a

comprehensive pain assessment clinic in primary care. Journal of Interprofessional

Education & Practice, 4(7), 100541. https://doi.org/10.1016/j.xjep.2022.100541

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This article providing an overview of communication tools and approaches in a

Comprehensive Pain Assessment Clinic (CoPAC) is a very applied and useful for

clinicians working in the field of multimodal pain management. It is most helpful for

clinicians, educators, and administrators involved in developing or enhancing

interprofessional pain management initiatives. The strength of the resource is that it

provides concrete examples of the particular communication techniques and instruments,

including pre-visit preparation sheets, team huddles, and handoff communication tools

that can be used to improve the interprofessional team work and patient outcomes. In this

aspect, this resource is useful in fulfilling the need for a functional and dynamic model of

teamwork, and may help to mitigate the risk of inadequate pain assessment and treatment

resulting from poor communication between team members. The use of learners’

qualitative feedback enhances the richness of the resource and gives an understanding of

the educational relevance of such inter-disciplinary clinics. This toolkit may be used by

healthcare professionals to organize their own interprofessional pain management clinics,

facilitate communication within the existing teams, and improve the training of

healthcare learners in pain management. This resource would be most useful in cases

where healthcare organizations are planning to create new interdisciplinary pain clinics,

address the lack of effective communication between the members of the current pain

management team, or expand the training programs for students and residents in the

sphere of pain management.

Torunn Hatlen Nøst, Tone Dahl-Michelsen, Hanne Aandahl, & Aslak Steinsbekk. (2024).

Healthcare professionals’ experiences of interdisciplinary collaboration in pain centres –

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A qualitative study. Scandinavian Journal of Pain, 24(1). https://doi.org/10.1515/sjpain-

2023-0132

The findings of this qualitative study on healthcare professionals’ experiences of

interdisciplinary collaboration in pain centres offer useful information for those who are

involved in the development and enhancement of interdisciplinary pain management

programs. It is most valuable for healthcare managers, chronic pain clinicians, and team

coordinators in interdisciplinary pain management teams. The value of the resource is in

the description of the actual problems and opportunities of interdisciplinary collaboration

in pain centers and the understanding of how different specialists can collaborate. In this

way, by presenting both the benefits and possible tensions of interdisciplinary work, this

study assists healthcare personnel in identifying risks that may result in suboptimal pain

control. The focus on the need to have a shared philosophy and the need to be constantly

communicating with other team members offers direction on how to develop better

integrated and efficient pain management teams. This resource can be helpful to

healthcare professionals to enhance the team functioning, to solve the potential conflicts

and to develop the supportive conditions for the effective interdisciplinary collaboration

in the context of pain management. This toolkit would be most useful in cases where pain

centres are facing problems in team work, interested in enhancing the interdisciplinary

model of care, or in the process of developing new pain services. It provides useful

information on how to design training interventions to improve interprofessional

collaboration and how to design policies that foster interprofessional practice in pain

management contexts.
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Innovative Technologies and Tools for Pain Assessment, Monitoring, and Intervention in

Clinical Practice

Mohsen Hassan Altobige, Mohsen Hassan Altobige, Kholoud Mohammed Alsubaie, Fahad

Altowairqi, & Abdulrahman Mohammed Alzahrani. (2024). Interventions for assessment

and enhancement of pain management competencies among healthcare professionals.

International Journal of Religion, 5(11), 3377–3383. https://doi.org/10.61707/axbyc911

This resource is most useful for healthcare administrators, educators, and clinical leaders

who have the responsibility for enhancing pain management competencies of healthcare

staff. It provides a broad approach to improving pain assessment and management

competencies, and as such, is valuable for designing training curricula and for the

application of quality improvement projects. The article’s focus on multimodal therapy,

the need for constant education, and technology-based solutions gives a comprehensive

view of how to solve the problem of insufficient pain management. Through the

emphasis on proper pain assessment methods and teamwork, this tool can greatly help in

minimising patient safety issues related to inadequate pain control. The strength of this

resource is that it provides specific recommendations for the training of programs and the

promotion of pain management practices. This toolkit can be used by healthcare

organizations to develop and execute pain management education programmes,

incorporate technology-based solutions for pain evaluation, and foster interprofessional

practice. This resource would be most useful in cases where individual healthcare

facilities are seeking to upgrade their pain management practices, increase staff

knowledge, or adopt new tools for pain assessment. It offers a framework for developing
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a new culture of patient-centred care for pain that will enhance patient experiences and

outcomes.

Hadjiat, Y., & Arendt-Nielsen, L. (2023). Digital health in pain assessment, diagnosis, and

management: Overview and perspectives. Frontiers in Pain Research (Lausanne,

Switzerland), 4(3), 1097379. https://doi.org/10.3389/fpain.2023.1097379

This article provides a comprehensive guide to digital health in the assessment, diagnosis,

and management of pain, which is valuable for practitioners and managers who want to

incorporate new technologies into their pain management plans. It is especially helpful

for those who are involved in the process of implementing quality and safety changes in

pain management because it gives an understanding of how digital health solutions can

solve traditional problems in pain evaluation and treatment. The strength of the resource

is that it offers an extensive analysis of the possibilities of digital health in pain

management, such as the possibility of obtaining more objective data on the patient’s pain

and individualized approaches to its treatment. As this resource explains how digital

health can help to address the challenges of managing pain, it provides approaches that

can greatly minimize patient safety hazards related to insufficient pain management. This

toolkit can be helpful for healthcare professionals to assess and integrate digital health

solutions into their pain management practice to enhance the validity of pain assessment

and the efficacy of pain management interventions. This resource would be especially

useful in cases when healthcare facilities are interested in updating their pain

management strategies, adopting telemedicine solutions for pain treatment, or creating

more effective pain management monitoring systems. It provides recommendations on

how to implement digital health solutions within a system that promotes health equity
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and evidence-based practice, which makes it a valuable resource for health care

organizations that seek to enhance their capacity to manage pain effectively while

responding to the needs of patients.

Darnall, B. D., Edwards, K. A., Courtney, R. E., Ziadni, M. S., Simons, L. E., & Harrison, L. E.

(2023). Innovative treatment formats, technologies, and clinician trainings that improve

access to behavioral pain treatment for youth and adults. Frontiers in Pain Research, 4(9).

https://doi.org/10.3389/fpain.2023.1223172

This scoping review of innovative treatment formats, technologies, and clinician trainings

for behavioural pain treatment is a valuable reference for healthcare practitioners who are

interested in enhancing the availability of effective pain management interventions. It is

especially helpful for pain management physicians, psychologists, and managers who are

charged with designing and managing pain management programs. The value of the

resource is in the fact that it is devoted to the description of the obstacles to the use of

behavioral pain treatments, which are effective but underutilized. This source provides

solutions that can greatly minimize the risk of inadequate pain management because of

the lack of access to proper treatments through presenting new technologies and

innovative treatment formats. The focus on both children and adults’ pain management

makes it general and can be used in different healthcare facilities. This toolkit will help

healthcare professionals to incorporate digital pain education and treatment tools, create

more effective behavioral pain interventions, and enhance the sustainability of their pain

management initiatives. This resource would be most useful in situations where

healthcare organizations are experiencing a shortage of pain-trained staff, considering the

use of telehealth for pain management, or interested in expanding their behavioral pain
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treatment services. It gives information about innovative strategies that can be used to

address system-level challenges to the management of pain in healthcare systems, which

may result in better patient outcomes and decreased costs related to chronic pain.

Patient-Centered Approaches and Education Strategies for Improving Pain Management

Outcomes

Seilern, J., Schenker, M. L., Port, A., Leslie, S., & Giordano, N. A. (2023). A systematic review

of patient-centered interventions for improving pain outcomes and reducing opioid-

related risks in acute care settings. 6, 6(1), e226–e226.

https://doi.org/10.1097/oi9.0000000000000226

The findings of this systematic review can be useful for healthcare practitioners and

policymakers who are involved in enhancing pain management and minimising the risks

of opioid use in the acute care context. The resource is useful as it focuses on the

multimodal analgesic requirements of orthopedic surgical patients who are known to be

at high risk of opioid prescription. In this regard, the review offers patient-centered

interventions that can be adopted to enhance pain management while minimising opioid

risks. This approach is important in minimizing patient safety hazards associated with

poor pain management and possible opioid abuse. The value of the resource is in its

ability to inform the design of context-specific interventions that can help clinicians

achieve the dual aim of managing patients’ pain while minimizing opioid use, an area

where practice is currently lacking. This toolkit will be useful for healthcare providers,

especially orthopedic surgeons and pain management specialists, to make decisions,

educate patients, and create a comprehensive pain management plan that minimizes

opioid use but still provides sufficient pain relief. Furthermore, the comparison with
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European practices provides a wider view and makes the healthcare systems think about

other ways of managing pain that can potentially reduce the harms of opioid prescribing

but still address the patients’ pain.

O’Brien, M. (2021). Pain coping skills training un-locks patient-centered pain care during the

covid- 19 lock-down. Pain Management Nursing, 4(6).

https://doi.org/10.1016/j.pmn.2021.10.007

This resource is most useful for healthcare providers, especially APRNs, who are looking

for patient-centered pain management during difficult situations like the COVID-19

pandemic. The emphasis on Pain Coping Skills Training (PCST) offers a useful

instrument for working with insufficient pain management in healthcare, particularly in

cases where face-to-face interventions are not possible. Through the promotion of self-

care and self-management, this approach can prevent many patient safety hazards related

to pain and possible opioid abuse. The value of the resource is in the provision of

practical approaches for patients with chronic pain, which may help to decrease the use of

medications and increase the quality of life. This toolkit is helpful for APRNs and other

healthcare professionals to apply PCST interventions in the APRNs’ practice, including in

the limited or rural access to healthcare environments. This is especially important in

cases where patients may not be able to access healthcare services easily, for instance

during the lockdowns or in the rural areas. The emphasis on enhancing self-efficacy as an

outcome variable gives a clear guide on how to evaluate the impact of these

interventions. Furthermore, the biopsychosocial approach promoted in this resource is

consistent with the modern guidelines for pain management and can be useful for

enhancing pain management programs in different healthcare organizations.

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Themelis, K., & Tang, N. K. Y. (2023). The management of chronic pain: re-centering person-

centered care. Journal of Clinical Medicine, 12(22), 6957.

https://doi.org/10.3390/jcm12226957

This review offers a broad and progressive view of person-centered care in chronic pain

and is therefore useful for healthcare professionals, policy makers and researchers who

are interested in quality and safety improvements in pain management. The focus on

going beyond the application of generic protocols and taking into account the variability

of pain experience is a major deficiency of current approaches to pain management. It is

especially useful in minimising patient safety risks arising from poor pain management

by advocating for individualised approaches to chronic pain management that take into

account the patient’s overall life and identity. The discussion of new directions, such as

the combination of traditional and individual formulations and self-monitoring

technologies, provides useful instruments for practitioners to improve the assessment of

pain and individualization of the management plan. It can be implemented by the

multidisciplinary pain management teams to enhance the understanding of the patients

and the development of more patient-centered treatment plans. It is most useful in

difficult cases where usual treatments have not worked or where the patient has special

requirements that are not met by standard care. Moreover, the emphasis on the patient’s

role in monitoring and managing their condition reflects the current trends in patient

engagement and shared decision-making in the healthcare context, which makes this

resource highly relevant for healthcare systems that are interested in implementing

patient-centered approaches to pain management.

Conclusion
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This toolkit provides healthcare practitioners with research-backed pain management best

practices. Real-world pain management solutions for guideline adherence, interprofessional

collaboration, technology, and patient engagement are presented in the selected materials. Users

can readily find pain management resources in the annotated bibliography. Healthcare

organizations may learn, collaborate, and enhance pain care using this toolkit to create a culture

of safety and quality. These tools can help healthcare providers standardize, improve, and

patient-center pain management, improving patient safety, satisfaction, and outcomes. Due to the

complexity of pain management in diverse healthcare settings, more practice and evidence-based

toolkits are needed.

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References

Chen, M.-C., Yeh, T.-F., Wu, C.-C., Wang, Y.-R., Wu, C.-L., Chen, R., & Shen, C.-H. (2023).

Three-year hospital-wide pain management system implementation at a tertiary medical

center: Pain prevalence analysis. PLOS ONE, 18(4), e0283520.

https://doi.org/10.1371/journal.pone.0283520

Connell, N., Pallavi Prathivadi, Lorenz, K. A., Zupanc, S. N., Singer, S. J., Krebs, E. E., Yano,

E. M., Wong Connie C, & Giannitrapani, K. F. (2022). Teaming in interdisciplinary

chronic pain management interventions in primary care: a Systematic Review of

Randomized Controlled Trials. Journal of General Internal Medicine, 37(6), 1501–1512.

https://doi.org/10.1007/s11606-021-07255-w

Darnall, B. D., Edwards, K. A., Courtney, R. E., Ziadni, M. S., Simons, L. E., & Harrison, L. E.

(2023). Innovative treatment formats, technologies, and clinician trainings that improve

access to behavioral pain treatment for youth and adults. Frontiers in Pain Research,

4(9). https://doi.org/10.3389/fpain.2023.1223172

Glassburn, S., Delbridge, E., Loghmani, M. T., Newton, A. D., Binion, K., Romito, L., & Willis,

D. R. (2022). Communication tools and strategies for interprofessional teamwork in a

comprehensive pain assessment clinic in primary care. Journal of Interprofessional

Education & Practice, 4(7), 100541. https://doi.org/10.1016/j.xjep.2022.100541

Hadjiat, Y., & Arendt-Nielsen, L. (2023). Digital health in pain assessment, diagnosis, and

management: Overview and perspectives. Frontiers in Pain Research (Lausanne,

Switzerland), 4(3), 1097379. https://doi.org/10.3389/fpain.2023.1097379

Mohsen Hassan Altobige, Mohsen Hassan Altobige, Kholoud Mohammed Alsubaie, Fahad

Altowairqi, & Abdulrahman Mohammed Alzahrani. (2024). Interventions for assessment

 17

and enhancement of pain management competencies among healthcare professionals.

International Journal of Religion, 5(11), 3377–3383. https://doi.org/10.61707/axbyc911

O’Brien, M. (2021). Pain coping skills training un-locks patient-centered pain care during the

covid- 19 lock-down. Pain Management Nursing, 4(6).

https://doi.org/10.1016/j.pmn.2021.10.007

Pereira, V. C., Silva, S. N., Carvalho, V. K. S., Zanghelini, F., & Barreto, J. O. M. (2022).

Strategies for the implementation of clinical practice guidelines in public health: an

overview of systematic reviews. Health Research Policy and Systems, 20(1).

https://doi.org/10.1186/s12961-022-00815-4

Salamon, K. S., Russell, C., DeVinney, D., & Soprano, C. M. (2024). Quality improvement

protocol: improving the use of nonpharmacological pain management strategies within

the inpatient hospital setting. Journal of Clinical Medicine, 13(6), 1680–1680.

https://doi.org/10.3390/jcm13061680

Seilern, J., Schenker, M. L., Port, A., Leslie, S., & Giordano, N. A. (2023). A systematic review

of patient-centered interventions for improving pain outcomes and reducing opioid-

related risks in acute care settings. 6, 6(1), e226–e226.

https://doi.org/10.1097/oi9.0000000000000226

Themelis, K., & Tang, N. K. Y. (2023). The Management of Chronic Pain: Re-Centring Person-

Centred Care. Journal of Clinical Medicine, 12(22), 6957.

https://doi.org/10.3390/jcm12226957

Torunn Hatlen Nøst, Tone Dahl-Michelsen, Hanne Aandahl, & Aslak Steinsbekk. (2024).

Healthcare professionals’ experiences of interdisciplinary collaboration in pain centres –

 18

A qualitative study. Scandinavian Journal of Pain, 24(1).

https://doi.org/10.1515/sjpain-2023-0132