Applying quality improvement methods to implement a measurement system for chronic pain-related disability

Objective This article describes the application of quality improvement methodology to implement a measurement tool for the assessment of functional status in pediatric patients with chronic pain referred for behavioral intervention. Methods The Functional Disability Inventory (FDI), a validated instrument for assessment of pain-related disability, was chosen as the primary clinical outcome measure. Using improvement science methodology, PDSA (Plan-Do-Study-Act) cycles were run to evaluate: (a) regular FDI administration, (b) two administration methods, (c) regular patient feedback, and (d) documentation methods. Results Within 1 month, psychologists were administering the FDI at least 80 % of the time to patients. A high level of reliability using two administration methods (92.8%) was demonstrated. The FDI was feasible to integrate into clinical practice. Modifications to electronic records further enhanced clinician reliability of documentation. Conclusions Quality improvement methods are an innovative way to make process changes in pediatric psychology settings to dependably gather and document evidence-based patient outcomes. Key words Functional Disability Inventory (FDI); pediatric pain; quality improvement. The Institute of Medicine (IOM) issued two landmark reports in 1999 and 2001, (‘‘To Err is Human,’ ’ and ‘‘Crossing the Quality Chasm’’), citing the frequency of patients receiving insufficient, unsafe care and calling for a redesign of the United States healthcare system