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Plan, Do, Check, Act Cycle Model Can Be Used for Ensuring the Quality Improvement of Pain Assessment Recording

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Background: Pain assessment is a crucial step and can be a key performance indicator (KPI) in healthcare and effective pain management for patients. In this study, we investigated the effectiveness of a quality improvement (QI) initiative using the Plan-Do-Check-Act (PDCA) model to enhance the rate and quality of pain assessments in hospitalized patients after medication administration. Method: In our study, the KPI of pain assessment was the percentage of hospitalized patients who had a pain scale record within 30 minutes after receiving injectable analgesics as per physician orders (both STAT and PRN). The percentage was very low (7.87%) during 2020.07-2021.06, and the pain care team used the root cause analysis (RCA) to identify the major causes in low percentage. According to RCA, we applied PDCA model into QI in pain assessment. Results: The implementation of PDCA model led to significant improvements in pain assessment rates, increasing from an initial 7.87% to 48.74% after the first phase and to 70.49% in the ongoing phase (P < 0.001). Different types of wards demonstrated a significant improvement trend over time (P for trend < 0.001), with surgical wards exhibiting the most notable effectiveness among all ward types. Conclusion: The application of the PDCA model effectively improved pain assessment rates. This QI strategy is feasible for other healthcare indicators, aiming to improve overall hospital care quality.