Fighting Dying Patients'Pain
National Campaign Will Strengthen Pain Control Standards
PRINCETON, N.J., August8, 1997--The University of Wisconsin-Madison Medical School will conduct acomprehensive nationwide effort to improve pain control for the dying in hospitals, The Robert Wood Johnson Foundation announced today. The three-year, $1.6 million project is a cooperative effort with the Joint Commission on Accreditation of Healthcare Organization and state cancer pain initiatives.
"Over the years many studies have shown that people are more afraid of the process of dying than of death itself," commented Foundation Senior Program Officer Rosemary Gibson. "And fear of unrelieved pain is one of the greatestworries thatpeople have when they face death. Unfortunately, studies also haveshown that, in many cases, people suffer needlessly, when modern pain control methods could alleviate their agony. This project will try to help health careproviders assess and treat pain in dying patients more effectively."
Under this project, the Wisconsin Cancer Pain Initiative--a national leader in encouraging better methods of pain control and in teaching health care professionalshow to use them--will work with the Joint Commission to develop new pain control standards. These standards will cover pain for terminally ill people with cancer and with other conditions. Ultimately, hospitals will have to meet these new standards in order to receive accreditation.
"We think the involvement of the Joint Commission in this project shows great foresight on the grantees part," Gibsonsaid. "Itprovides the motivation for health care institutions to take a serious look at pain control and implement more effective practices." The Joint Commission evaluates and accredits more than 18,000 health care organizations and programs in the United States. It is the nations preeminent standards-setting and accreditingbody in health care. To earn--and keep--accreditation, an organization must undergo an on-site inspection at least every three years.
As the approximately two-year standards development process begins, the projectpersonnel will coordinate a national quality improvement effort to help hospitals implement better procedures to assess and manage pain. Other organizations, such as State Peer Review Organizations, already have indicated their desire to assist in this quality improvement activity.
Many hospitals likewise are eager to improve theway pain is managed within their walls.
"The scienceof pain control continues to improve," said project director June L. Dahl, PhD,"but outmoded clinical practices, misconceptions about addiction, and our cultures mistaken assumption that dying is always painful--these things conspire to prevent the application of the best that science, when linked with compassion, can offer."
"Part of the motivation for this project came from the SUPPORTstudy, which the Foundation funded a few years ago," Gibson said. "It found that half of seriously illpatients, who were able to communicate in their last days, were in severepain. This disturbing finding--and others from SUPPORT--have galvanized many health care leaders to try to change the way we care for the dying. Many of these leadershave joined us in a campaign called Last Acts: Care and Caring at the End of Life, chaired by former first lady Rosalynn Carter. The new University of Wisconsin project will fill an important niche in this effort and an opportunity for positive action."
The Robert Wood Johnson Foundation, based in Princeton, N.J., is the nation's largest philanthropy devoted exclusively to health and health care. It became a nationalinstitution in 1972 with receipt of a bequest fromthe industrialist whose nameit bears, and has since made more than $2 billion in grants. The Foundation concentrates its grantmaking in three goal areas: to assure that all Americans haveacc mess to basic health care at reasonable cost; toimprove the way services are organized and provided to people with chronic health conditions; and to reduce the personal, social and economic harm caused by substance abuse--tobacco, alcohol, and illicit drugs.
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