The impact of a simplified documentation method for the Edmonton classification system for cancer pain (ECS-CP) on clinician utilization

Purpose The use of standardized pain classification systems such as the ECS-CP can assist in the assessment and management of cancer pain. However, its completion has been limited due to its perceived complexity of decoding each feature. The objectives of this study were to determine the rate of cli...

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Vydáno v:	Supportive care in cancer Ročník 25; číslo 2; s. 575 - 580
Hlavní autoři:	Tanco, Kimberson, Arthur, Joseph, Haider, Ali, Stephen, Saneese, Yennu, Sriram, Liu, Diane, Bruera, Eduardo
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	Berlin/Heidelberg Springer Berlin Heidelberg 01.02.2017 Springer Springer Nature B.V
Témata:	Adult Analysis Cancer Cancer pain Cancer Pain - classification Classification Clinical medicine Decoding Documentation Documentation - methods Educational systems Female Humans Intervention Male Medicine Medicine & Public Health Methods Middle Aged Neoplasms - complications Nursing Nursing Research Oncology Original Article Pain Pain management Pain Measurement - methods Pain Medicine Palliative care Patients Physicians Practitioner patient relationship Rehabilitation Medicine Scores Simplification Specialists ECS-CP Cancer pain Standardized pain classification system Edmonton classification system for cancer pain Standardized pain score
ISSN:	0941-4355, 1433-7339, 1433-7339
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Abstract	Purpose The use of standardized pain classification systems such as the ECS-CP can assist in the assessment and management of cancer pain. However, its completion has been limited due to its perceived complexity of decoding each feature. The objectives of this study were to determine the rate of clinician documentation and completion of the ECS-CP features after revision and simplification of the response for each feature. Methods Electronic records of consecutive patient visits at the outpatient supportive care center seen by 12 palliative medicine specialists were collected at 6 months before (pre-interventional period), 6 and 24 months after (post-interventional period) the implementation of the simplified ECS-CP tool. Rate of ECS-CP documentation, completion, and analysis of patient and physician predictors were completed. Results One thousand and twelve patients’ documentation was analyzed: 343 patients, before; 341 patients, 6 months after, and 328 patients, 24 months after the intervention. ≥2/5 items were completed before the intervention, 6 months after the intervention and 24 months after intervention in 0/343 (0 %), 136/341 (40 %), and 238/328 (73 %), respectively ( p < 0.001). 5/5 items were completed before the intervention, 6 months after the intervention and 24 months after intervention in 0/343 (0 %), 131/341 (38 %), and 222/328 (68 %), respectively, ( p < 0.001). There were no patient or physician predictors found significant for successful documentation of ECS-CP. Conclusion Our findings suggest that significant simplification and intensive education is necessary for successful adoption of a scoring system. More research is needed in order to identify how to adopt tools for daily clinical practice in palliative care.
AbstractList	The use of standardized pain classification systems such as the ECS-CP can assist in the assessment and management of cancer pain. However, its completion has been limited due to its perceived complexity of decoding each feature. The objectives of this study were to determine the rate of clinician documentation and completion of the ECS-CP features after revision and simplification of the response for each feature. Electronic records of consecutive patient visits at the outpatient supportive care center seen by 12 palliative medicine specialists were collected at 6 months before (pre-interventional period), 6 and 24 months after (post-interventional period) the implementation of the simplified ECS-CP tool. Rate of ECS-CP documentation, completion, and analysis of patient and physician predictors were completed. One thousand and twelve patients' documentation was analyzed: 343 patients, before; 341 patients, 6 months after, and 328 patients, 24 months after the intervention. ≥2/5 items were completed before the intervention, 6 months after the intervention and 24 months after intervention in 0/343 (0 %), 136/341 (40 %), and 238/328 (73 %), respectively (p < 0.001). 5/5 items were completed before the intervention, 6 months after the intervention and 24 months after intervention in 0/343 (0 %), 131/341 (38 %), and 222/328 (68 %), respectively, (p < 0.001). There were no patient or physician predictors found significant for successful documentation of ECS-CP. Our findings suggest that significant simplification and intensive education is necessary for successful adoption of a scoring system. More research is needed in order to identify how to adopt tools for daily clinical practice in palliative care. The use of standardized pain classification systems such as the ECS-CP can assist in the assessment and management of cancer pain. However, its completion has been limited due to its perceived complexity of decoding each feature. The objectives of this study were to determine the rate of clinician documentation and completion of the ECS-CP features after revision and simplification of the response for each feature. Electronic records of consecutive patient visits at the outpatient supportive care center seen by 12 palliative medicine specialists were collected at 6 months before (pre-interventional period), 6 and 24 months after (post-interventional period) the implementation of the simplified ECS-CP tool. Rate of ECS-CP documentation, completion, and analysis of patient and physician predictors were completed. One thousand and twelve patients' documentation was analyzed: 343 patients, before; 341 patients, 6 months after, and 328 patients, 24 months after the intervention. [greater than or equal to]2/5 items were completed before the intervention, 6 months after the intervention and 24 months after intervention in 0/343 (0 %), 136/341 (40 %), and 238/328 (73 %), respectively (p < 0.001). 5/5 items were completed before the intervention, 6 months after the intervention and 24 months after intervention in 0/343 (0 %), 131/341 (38 %), and 222/328 (68 %), respectively, (p < 0.001). There were no patient or physician predictors found significant for successful documentation of ECS-CP. Our findings suggest that significant simplification and intensive education is necessary for successful adoption of a scoring system. More research is needed in order to identify how to adopt tools for daily clinical practice in palliative care. Purpose The use of standardized pain classification systems such as the ECS-CP can assist in the assessment and management of cancer pain. However, its completion has been limited due to its perceived complexity of decoding each feature. The objectives of this study were to determine the rate of clinician documentation and completion of the ECS-CP features after revision and simplification of the response for each feature. Methods Electronic records of consecutive patient visits at the outpatient supportive care center seen by 12 palliative medicine specialists were collected at 6 months before (pre-interventional period), 6 and 24 months after (post-interventional period) the implementation of the simplified ECS-CP tool. Rate of ECS-CP documentation, completion, and analysis of patient and physician predictors were completed. Results One thousand and twelve patients' documentation was analyzed: 343 patients, before; 341 patients, 6 months after, and 328 patients, 24 months after the intervention. [greater than or equal to]2/5 items were completed before the intervention, 6 months after the intervention and 24 months after intervention in 0/343 (0 %), 136/341 (40 %), and 238/328 (73 %), respectively (p < 0.001). 5/5 items were completed before the intervention, 6 months after the intervention and 24 months after intervention in 0/343 (0 %), 131/341 (38 %), and 222/328 (68 %), respectively, (p < 0.001). There were no patient or physician predictors found significant for successful documentation of ECS-CP. Conclusion Our findings suggest that significant simplification and intensive education is necessary for successful adoption of a scoring system. More research is needed in order to identify how to adopt tools for daily clinical practice in palliative care. Purpose The use of standardized pain classification systems such as the ECS-CP can assist in the assessment and management of cancer pain. However, its completion has been limited due to its perceived complexity of decoding each feature. The objectives of this study were to determine the rate of clinician documentation and completion of the ECS-CP features after revision and simplification of the response for each feature. Methods Electronic records of consecutive patient visits at the outpatient supportive care center seen by 12 palliative medicine specialists were collected at 6 months before (pre-interventional period), 6 and 24 months after (post-interventional period) the implementation of the simplified ECS-CP tool. Rate of ECS-CP documentation, completion, and analysis of patient and physician predictors were completed. Results One thousand and twelve patients’ documentation was analyzed: 343 patients, before; 341 patients, 6 months after, and 328 patients, 24 months after the intervention. ≥2/5 items were completed before the intervention, 6 months after the intervention and 24 months after intervention in 0/343 (0 %), 136/341 (40 %), and 238/328 (73 %), respectively ( p < 0.001). 5/5 items were completed before the intervention, 6 months after the intervention and 24 months after intervention in 0/343 (0 %), 131/341 (38 %), and 222/328 (68 %), respectively, ( p < 0.001). There were no patient or physician predictors found significant for successful documentation of ECS-CP. Conclusion Our findings suggest that significant simplification and intensive education is necessary for successful adoption of a scoring system. More research is needed in order to identify how to adopt tools for daily clinical practice in palliative care. The use of standardized pain classification systems such as the ECS-CP can assist in the assessment and management of cancer pain. However, its completion has been limited due to its perceived complexity of decoding each feature. The objectives of this study were to determine the rate of clinician documentation and completion of the ECS-CP features after revision and simplification of the response for each feature.PURPOSEThe use of standardized pain classification systems such as the ECS-CP can assist in the assessment and management of cancer pain. However, its completion has been limited due to its perceived complexity of decoding each feature. The objectives of this study were to determine the rate of clinician documentation and completion of the ECS-CP features after revision and simplification of the response for each feature.Electronic records of consecutive patient visits at the outpatient supportive care center seen by 12 palliative medicine specialists were collected at 6 months before (pre-interventional period), 6 and 24 months after (post-interventional period) the implementation of the simplified ECS-CP tool. Rate of ECS-CP documentation, completion, and analysis of patient and physician predictors were completed.METHODSElectronic records of consecutive patient visits at the outpatient supportive care center seen by 12 palliative medicine specialists were collected at 6 months before (pre-interventional period), 6 and 24 months after (post-interventional period) the implementation of the simplified ECS-CP tool. Rate of ECS-CP documentation, completion, and analysis of patient and physician predictors were completed.One thousand and twelve patients' documentation was analyzed: 343 patients, before; 341 patients, 6 months after, and 328 patients, 24 months after the intervention. ≥2/5 items were completed before the intervention, 6 months after the intervention and 24 months after intervention in 0/343 (0 %), 136/341 (40 %), and 238/328 (73 %), respectively (p < 0.001). 5/5 items were completed before the intervention, 6 months after the intervention and 24 months after intervention in 0/343 (0 %), 131/341 (38 %), and 222/328 (68 %), respectively, (p < 0.001). There were no patient or physician predictors found significant for successful documentation of ECS-CP.RESULTSOne thousand and twelve patients' documentation was analyzed: 343 patients, before; 341 patients, 6 months after, and 328 patients, 24 months after the intervention. ≥2/5 items were completed before the intervention, 6 months after the intervention and 24 months after intervention in 0/343 (0 %), 136/341 (40 %), and 238/328 (73 %), respectively (p < 0.001). 5/5 items were completed before the intervention, 6 months after the intervention and 24 months after intervention in 0/343 (0 %), 131/341 (38 %), and 222/328 (68 %), respectively, (p < 0.001). There were no patient or physician predictors found significant for successful documentation of ECS-CP.Our findings suggest that significant simplification and intensive education is necessary for successful adoption of a scoring system. More research is needed in order to identify how to adopt tools for daily clinical practice in palliative care.CONCLUSIONOur findings suggest that significant simplification and intensive education is necessary for successful adoption of a scoring system. More research is needed in order to identify how to adopt tools for daily clinical practice in palliative care.
Audience	Academic
Author	Liu, Diane Yennu, Sriram Stephen, Saneese Tanco, Kimberson Arthur, Joseph Bruera, Eduardo Haider, Ali
Author_xml	– sequence: 1 givenname: Kimberson surname: Tanco fullname: Tanco, Kimberson email: kctanco@mdanderson.org organization: Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center – sequence: 2 givenname: Joseph surname: Arthur fullname: Arthur, Joseph organization: Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center – sequence: 3 givenname: Ali surname: Haider fullname: Haider, Ali organization: Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center – sequence: 4 givenname: Saneese surname: Stephen fullname: Stephen, Saneese organization: Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center – sequence: 5 givenname: Sriram surname: Yennu fullname: Yennu, Sriram organization: Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center – sequence: 6 givenname: Diane surname: Liu fullname: Liu, Diane organization: Department of Biostatistics, The University of Texas MD Anderson Cancer Center – sequence: 7 givenname: Eduardo surname: Bruera fullname: Bruera, Eduardo organization: Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/27722795$$D View this record in MEDLINE/PubMed
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Cites_doi	10.1089/jayao.2014.0015 10.1017/S1478951514000108 10.1016/j.jpainsymman.2015.11.012 10.1016/S0140-6736(11)60236-5 10.1016/0885-3924(95)00052-Z 10.1089/jpm.2012.0390 10.1016/j.jpainsymman.2004.05.008 10.1017/S1478951514001205 10.1016/S0885-3924(01)00409-2 10.1016/j.jpainsymman.2004.08.010 10.1177/0269216309103125 10.1016/0304-3959(89)90131-0 10.1111/jonm.12368 10.1016/j.jpainsymman.2015.11.023 10.1017/S1478951513001351 10.1016/S0885-3924(97)00081-X 10.1634/theoncologist.2015-0012 10.1097/PPO.0b013e3182a631c5 10.1200/JCO.2008.17.1660
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Snippet	Purpose The use of standardized pain classification systems such as the ECS-CP can assist in the assessment and management of cancer pain. However, its... The use of standardized pain classification systems such as the ECS-CP can assist in the assessment and management of cancer pain. However, its completion has... Purpose The use of standardized pain classification systems such as the ECS-CP can assist in the assessment and management of cancer pain. However, its...
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SubjectTerms	Adult Analysis Cancer Cancer pain Cancer Pain - classification Classification Clinical medicine Decoding Documentation Documentation - methods Educational systems Female Humans Intervention Male Medicine Medicine & Public Health Methods Middle Aged Neoplasms - complications Nursing Nursing Research Oncology Original Article Pain Pain management Pain Measurement - methods Pain Medicine Palliative care Patients Physicians Practitioner patient relationship Rehabilitation Medicine Scores Simplification Specialists
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Title	The impact of a simplified documentation method for the Edmonton classification system for cancer pain (ECS-CP) on clinician utilization
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