Pain Care Pathways and Patient Reported Outcomes

Introduction

Effective postoperative pain management is critical for successful recovery after surgery, contributing both to positive clinical outcomes and patient satisfaction. Traditional practice has relied on opioid medications as a primary mode of pain management. Although these medications have provided pain control, their role in the escalating opioid use disorder epidemic cannot be ignored. Opioids are overprescribed after surgery, with studies indicating 72% of opioids remain unused. These leftover opioids create opportunities for misuse and diversion into communities. Exposure to opioids may result in new, persistent opioid use for up to 6% of patients after both minor and major surgery.

The reasons for overprescribing opioids after surgery are beyond the scope of this chapter. Nonetheless, right-sizing opioid prescribing is a key priority for both the opioid-naïve and chronic opioid using patient. Creating institutional change for opioid prescribing can best be achieved using various continuous quality improvement frameworks. To do this, patient feedback is critical; thus a system for patient-reported outcomes must be established. We will detail successful opioid prescribing change within a single institution and across a state using the Plan-Do-Check-Act (PDCA) or Plan-Do-Study-Act (PDSA) approach.