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Journal of Pediatric Psychology Advance Access published online on March 6, 2009
Journal of Pediatric Psychology, doi:10.1093/jpepsy/jsp001
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© The Author 2009. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Applying Quality Improvement Methods to Implement a Measurement System for Chronic Pain-Related Disability

Anne M. Lynch-Jordan, PhD1,2, Susmita Kashikar-Zuck, PhD1,2, Lori E. Crosby, PsyD1,2, Wendi L. Lopez, PhD1, Beverly H. Smolyansky, PhD1, Irina S. Parkins, PhD1, Carolyn P. Luzader, MS3, Abigail Hartman, BS1, Shanna M. Guilfoyle, MA1 and Scott W. Powers, PhD1,2

1Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 2College of Medicine, University of Cincinnati, and 3Center for Health Policy and Clinical Effectiveness, Cincinnati Children's Hospital Medical Center

All correspondence concerning this article should be addressed to Anne M. Lynch-Jordan, PhD, Assistant Professor of Pediatrics & Anesthesiology, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML 3015, Cincinnati, OH 45229, USA. E-mail: anne.lynch-jordan{at}cchcm.org


  Abstract

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..

Received August 28, 2008; revision received December 30, 2008; accepted January 5, 2009


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