Better pain management after total joint replacement surgery: a quality improvement approach.

Following the implementation of an innovative analgesic and pain management pathway for patients undergoing total joint replacement at Virginia Mason Medical Center, a multidisciplinary team of providers identified additional pain management needs related to patient education and communication. Utilizing several quality improvement strategies, including a "gemba walk" and a "Plan, Do, Study, Act" methodology, a comprehensive, evidence-based patient education tool was developed. The quality improvement process detailed in this article focuses on outcomes related to enhanced patient and provider communication, enhanced patient education, and accurate provider pain assessment. The framework that is presented can be applied to many problems that may exist in the acute care setting.