Hospitals Told to Get Serious About Pain

W A S H I N G T O N, Dec. 25 -- When you enter a hospital, you have a right to have your pain properly treated.

That sounds so common-sense, yet millions of Americans sufferevery day because pain is routinely ignored or undertreated.

But starting next week, the nation’s hospitals must make a major change: New standards require that every patient’s pain be measured regularly from the time they check in — just like other vital signs are measured — and proper pain relief begun or the hospitals risk losing their accreditation.

Patients should expect at least to be asked to rate how they’re feeling, from zero, no pain, to 10, the worst pain imaginable. (Small children will use pictures to rate pain.) The score determines what steps the hospital must take to help.

To stress how important the changes are, the new standards actually put in writing that “patients have the right” to proper pain assessment and treatment.

Some hospitals already are handing out leaflets and posting signs in the halls telling patients about that right, so they know it’s OK — nay, crucial — to complain if a doctor or nurse doesn’t help.

Better, it’s not just hospitals that must take the new steps but nursing homes and outpatient clinics accredited by the Joint Commission on Accreditation of Healthcare Organizations. The commission adopted the standards over a year ago, but gave facilities until January to comply.

A ‘Watershed Event’

It’s “a watershed event,” said Dr. Russell Portenoy, pain medicine chairman of New York’s Beth Israel Medical Center. “No one has ever promised patients no pain. But what JCAHO wants to do is promise people their pain will be assessed and managed in a state-of-the-art way.”

Many centers still are scrambling to comply. Teaching health workers who aren’t pain specialists how to treat can take some time—and many doctors inappropriately shun narcotics, a treatment mainstay for numerous types of pain, because they think patients will get hooked on them.