Pain Plan of Care

Measure Purpose: To manage pain

The numerator: Patients that have a follow-up plan* documented (including created by another provider) when pain is present at the visit where pain assessment is positive.

*Follow-up plan: A documented outline of care for positive pain assessment. This must include a planned follow-up appointment or referral, a notification to other care providers as applicable OR indicate initial treatment plan is still in effect. These plans may include pharmacologic, behavioral, physical medicine and/or educational interventions.

is divided by

The denominator: All patients that have a positive pain assessment

Exclusions:

• Severe mental and/or physical incapacity where the person is unable to express himself/herself in a manner understood by others. For example, cases where pain cannot be accurately assessed through use of nationally recognized standardized pain assessment tools. 
• Patient and/or caregiver refuse to participate
• Patient is in palliative care

Key Phrases

Examples of key phrases you might use to meet the measure:

• Pain plan discussed
• Pain plan documented

Measure Calculation Example

Dr. Romano saw 50 patients with neurological conditions that had a positive pain assessment from January 1 to December 31 of the measurement year. This is the denominator. Two patients were in palliative care and one refused to participate. These patients are removed from the denominator.

Of the remaining 47 patients, 15 had a pain plan of care developed. This is the numerator.

Quality of care =15/(50-3). Dr. Romano has a score of 31% for this measure.