On January, 1, 2018, The Joint Commission’s (“TJC”) new and revised pain assessment and management standards go into effect for TJC accredited hospitals. The changes to the standards stem from a review commenced by The Joint Commission in 2016 to bring the preceding accreditation standards into alignment with leading practices in pain assessment and management, and the safe use of opioids. In light of these standards, hospitals and their medical staffs should review their current policies, protocols, and procedures to ensure their practices comply with the new TJC requirements.

Among the revised standards are requirements for:

  • Identifying a leader or leadership team that is responsible for pain management and safe opioid prescribing.
  • Screening of patients for pain during emergency department visits and at time of admission
  • Identifying and monitoring patients at risk for adverse outcomes related to opioid treatment.
  • Establishing criteria to screen, assess, and reassess pain that are consistent with the patient’s age, condition, and ability to understand.
  • Involving patients in the developing of their treatment plans through setting realistic expectations and measurable goals and discussing objectives used to evaluate treatment progress.
  • Developing pain treatment plans based on evidence-based practices and the patient’s clinical condition, past medical history, and pain management goals.
  • Assessing and managing the patients’ pain and minimizing the risks associated with treatment.
  • Providing nonpharmacologic pain treatment modalities.
  • Involving the medical staff in pain assessment, pain management, and safe opioid prescribing through participation in the establishment of protocols and quality metrics, and review of performance improvement data.
  • Educating staff and licensed independent practitioners on resources and programs regarding pain assessment, pain management, and the safe use of opioid medications based on the identified needs of the patient population.
  • Acquiring equipment needed to monitor patients who are at high risk for adverse outcomes from opioid treatment.
  • Identifying opioid treatment programs that can be used for patient referrals.
  • Providing information to staff and licensed independent practitioners on available services for consultation and referral of patients with complex pain management needs.
  • Educating patients and their families on discharge plans related to pain management including, side effects of pain management treatment, and the safe use, storage, and disposal of opioids.
  • Collecting and analyzing data on pain assessment and pain management, including types of interventions and effectiveness.
  • Conducting performance improvement activities focusing on pain assessment and management to increase safety and quality for patients (e.g., tracking adverse events).
  • Facilitating practitioner access to Prescription Drug Monitoring Program databases.

The full text of the new and revised requirements is posted on The Joint Commission website and will be reflected in the Fall 2017 E-dition Standards and 2018 hard copy publication. Standards affected include: LD 04.03.13 (Eps 1-7), MS 03.01.03, MS.05.01.01 (EP 18), PC.01.02.07 (EPs 1-8), PI.01.01.01 (EP 56), and PI.02.01.01 (Eps 18 and 19).

Additional post related to pain and opioids:

Medical Board of California Circulates Opioid Prescriber Guidance