QUIPS
QUIPS is the abbreviation for quality improvement in postoperative pain therapy . It describes a medical benchmark project in which pain therapy after surgical operations is statistically processed and improved through patient surveys.
target
In nature, pain has a warning function, but acute pain after an operation does not. For example, they slow the healing process, cause complications and, if not properly treated, can become chronic. Poor pain management puts those affected at risk, causes unnecessary suffering and increases treatment costs. International studies show that pain therapy after operations is still problematic today, as adequate pain management is not yet implemented in most hospitals.
The aim of QUIPS is to improve this therapy by continuously collecting data on the quality of the results of the therapy, analyzing this data and providing feedback to the clinics involved. Better management of pain and other post-operative ailments can help shorten hospital stays and increase patient satisfaction. Therefore, the focus of QUIPS is on the quality of results from the patient's perspective.
method
On the first day after the operation, parameters of the outcome quality (pain intensity with a numerical rating scale , functional limitations, side effects) and selected clinical demographic data (age, gender, type of operation, medication) are recorded in a patient questionnaire from a representative sample of patients. The data is anonymized and sent to a central database. It is not possible to draw conclusions about individual patients.
A web front end enables data analysis for participating clinics. To do this, the participants log in via the Internet. You can then call up individualized temporal evaluations and compare them with each other. This enables you to read the effects of changes in the process parameters (e.g. administration of a different medication, cooling) directly. In addition to the statistical analysis, selected clinics with good as well as bad results show their pain therapy on the website and thus enable other project participants to compare their approach and adjust it if necessary.
history
QUIPS was and is being developed at the Jena University Hospital since 1998. It was originally funded by the Federal Ministry of Health . Today it is self-financed and supported by various partners, such as the German Society for Anesthesiology and Intensive Care Medicine , the German Society for Surgery , the Professional Association of German Anesthesiologists and the Professional Association of German Surgeons .
Currently (January 2014) 190 clinics from Germany, Austria and Switzerland are participating in QUIPS. The database currently (January 2014) contains around 333,000 anonymized data records. In the EU-funded partner project PAIN OUT , the idea of QUIPS has been extended to Europe and developed further since 2009.
literature
- JL Apfelbaum, C. Chen, SS Mehta, TJ Gan: Postoperative pain experience: results from a national survey suggest postoperative pain continues to be undermanaged. In: Anesthesia Analgesia. 97 (2), 2003 Aug, pp. 534-540.
- JL Dahl, D. Gordon, S. Ward, M. Skemp, S. Wochos, M. Schurr: Institutionalizing pain management: the Post-Operative Pain Management Quality Improvement Project. In: Journal of Pain. 4 (7), 2003 Sep, pp. 361-371.
- HC Diener, C. Maier: The pain therapy. Elsevier, 2008.
- W. Meissner, S. Mescha, J. Rothaug, S. Zwacka, A. Göttermann, K. Ulrich, A. Schleppers: Quality improvement of postoperative pain therapy. Results of the QUIPS project. In: Deutsches Ärzteblatt. 105 (50), 2008, pp. 865-870.
- W. Meissner, K. Ullrich, S. Zwacka: Benchmarking as a tool of continuous quality improvement in postoperative pain management. In: European Journal of Anaesthesiology. 23 (2), 2006 Feb, pp. 142-148.
- W. Pipam, G. Bernatzky, R. Likar: Pain measurement and documentation. Springer, 2007.