Operationalizing Multidisciplinary Assessment and Treatment as a Quality Metric for Interventional Pain Practices.

Objective: Quality improvement (QI) is an underutilized approach among pain medicine specialists to improve comprehensive pain assessment and the delivery of multimodal pain care. We report the results of a QI program that utilized peer review and financial incentives to improve these processes in interventional pain clinics.

Design: Retrospective chart review.

Setting: Eight academic and community-based practices that included separate hospital-based and non-hospital-based interventional pain clinics.

Subjects: Results of chart audits by nine academic pain medicine physicians.

Methods: An audit of a random sample of each pain physician's charts was periodically examined for mention and discussion of specific components of multidisciplinary pain care. A portion of the physician's incentive payment was withheld if less than 70% of charts were compliant. The rates of compliance after the intervention for the group were compared.

Results: Before this program was instituted, an audit of 10 patient charts from each of the nine pain medicine physicians revealed only a 13% baseline rate of compliance. After the audit system was implemented, 90% of all patient charts were compliant during the first 12-month period (P < 0.01 for the change in rate of compliance).

Conclusions: The results of this QI project suggest that pain clinics can make this value-based transition and offer high-quality multidisciplinary assessment and treatment, with good compliance among a group of physicians in primarily intervention-based practices.