Clinical governance and chronic pain: towards a practical solution

Abstract

Summary There have been many studies into the effectiveness of single interventions in pain, however, little is known of performance or outcome of pain clinics where treatment often consists of multiple, complex interventions. Many pain clinicians currently experience considerable difficulty in fulfilling the requirements of clinical governance and completing a personal portfolio. There is a clear and urgent need for a viable method of monitoring performance. This study describes a well‐developed computer‐based system – Pain Audit Collection System (PACS). PACS has been designed by pain clinicians through consensus and its success in uptake suggests that it is a viable method for outcome evaluation. An analysis is provided of outcome data in typical pain clinics. Further work is needed to investigate the utility of this data.

Development and Implementation of a Registry of Patients Attending Multidisciplinary Pain Treatment Clinics: The Quebec Pain Registry

“…Based on our literature review, there are only two other longitudinal registries which have been implemented in multidisciplinary pain treatment clinics, that is, the PACS [17] (also named PainDB [57]) and the CHOIR [18]. However, a validation study on the quality of the PainDB concluded that this registry was unsuitable for research purposes [57].…”

“…This gave the impetus to implement in the Quebec Pain Registry (QPR) project designed to serve both clinical/administrative and research purposes. To our knowledge, only two other registries of patients with various types of chronic pain disorders treated in multidisciplinary clinics have been developed so far, one in the UK (Pain Audit Collection System) [17] (PACS) and one in the US (Collaborative Health Outcomes Information Registry (CHOIR) [18]). However, their data collection procedures differ from those used in the QPR whose content is also richer in terms of clinical/medical data and outcome measures.…”

Validation of the quality of The National Pain Database for pain management services in the United Kingdom

“…Although datasets have been described for pain clinics [6] little research and no validation has been published from these resources. One potential source of information on pain management is the PainDB [7] collected predominantly by clinicians at pain clinics throughout the UK. PainDB was developed by the Clinical Information Special Interest Group of the British Pain Society (BPS) which is responsible for its maintenance and upkeep.…”

“…Developed predominantly as a research and audit tool, it has the potential to provide information on case mix, treatments in outpatients, and outcomes, providing information not always included on standard UK NHS collection systems in outpatients. Data are collected using established coding systems and taxonomies with the majority of participants using a standard software package [7] A new database is created, as funding permits, on request to members to submit a download to a central site. Further details have been published elsewhere [7].…”

Meeting the challenge of clinical governance in pain management

“…Griffith's article [1] in this issue describes a tool (Pain Audit Collection System, PACS) which audits activity against a standard, helps the process of reappraisal, and is intended to be used for cross-boundary working and sharing. It has a great deal of support.…”