Making pain assessment and management a healthcare system priority through the new JCAHO pain standards

Unrelieved pain is a major-yet avoidable public health problem. Despite 20 years of work by educators, clinicians and professional organizations and the publication of clinical practice guidelines, there have been at best modest improvements in pain management practices. The failure to routinely assess and document pain, lack of access to practical treatment protocols, and the view that pain is an expected and relatively insignificant symptom continue to impede progress. In August of 1997 we began a collaborative project to integrate pain assessment and management for all patients into the standards, intent statements, and examples of implementation of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). This presented a rare opportunity to improve pain management in health care facilities throughout the country. The revisions were approved by the JCAHO Board of Commissioners in May of 1999, are published in the 2000 standards manuals and will be effective January 1, 2001 for all patient care organizations accredited by JCAHO. We are conducting an evaluation of the impact of the revisions and assisting with education of the JCAHO surveyors and healthcare professionals. Pharmacists are essential in interdisciplinary efforts to make pain assessment and management a priority in any healthcare setting.