Calcaterra Susan L, Drabkin Anne D, Doyle Reina, Leslie Sarah E, Binswanger Ingrid A, Frank Joseph W, Reich Jennifer A, Koester Stephen
a Department of Hospital Medicine , Denver Health Medical Center , Denver , Colorado , USA.
b Division of General Internal Medicine, Department of Medicine , University of Colorado School of Medicine , Aurora , Colorado , USA.
Hosp Top. 2017 Jan-Mar;95(1):18-26. doi: 10.1080/00185868.2017.1300479.
Hospital initiatives to promote pain management may unintentionally contribute to excessive opioid prescribing. To better understand hospitalists' perceptions of satisfaction metrics on pain management, the authors conducted 25 interviews with hospitalists. Transcribed interviews were systematically analyzed to identify emergent themes. Hospitalists felt institutional pressure to earn high satisfaction scores for pain, which they perceived influenced practices toward opioid prescribing. They felt tying compensation to satisfaction scores commoditized pain. Hospitalists believed satisfaction would improve with increased time spent at the bedside. Focusing on methods to improve patient-physician communication, while maintaining efficiency in clinical practice, may promote both patient-centered pain management and satisfaction.
医院促进疼痛管理的举措可能无意中导致阿片类药物处方过量。为了更好地了解住院医师对疼痛管理满意度指标的看法,作者对住院医师进行了25次访谈。对访谈记录进行了系统分析,以确定出现的主题。住院医师感到有机构压力要在疼痛方面获得高满意度评分,他们认为这影响了阿片类药物处方的做法。他们觉得将薪酬与满意度评分挂钩使疼痛变得商品化。住院医师认为,增加在床边的时间会提高满意度。在保持临床实践效率的同时,专注于改善医患沟通的方法,可能会促进以患者为中心的疼痛管理和满意度。