No pain after the operation: The QUIPS Project
Postoperative pain can be reduced. This has been shown by four of the six hospitals which took part in the project for quality improvement in postoperative pain management (QUIPS). The data from this project from the different hospitals can be compared using a benchmark server, allowing hospitals to identify deficiencies in the care they provide and to learn from other centers. Winfried Meissner and his colleagues present QUIPS in the current edition of Deutsches Ärzteblatt International (Dtsch Arztebl Int 2008; 105 [50]: 865-70). The scientists evaluated a total of 12 389 questionnaires, which patients had to complete on the first day after their operations. This covered parameters such as maximal pain, functional impairment, therapeutic side effects and the patient's individual evaluation, as well as clinical data, such as the type of operation, the anesthesia, and the analgesia. Cruciate ligament reconstruction was rated as the most painful operation. Forearm fracture osteosynthesis and partially cemented knee arthroplasty shared the second place. Next came laparoscopic appendectomy and laparoscopic sigmoid resection. It was surprising that patients regarded laparoscopic appendectomy as very painful, even though this is seen as a minor surgical procedure. According to the authors, this project indicated inadequate care and specified groups of patients at risk.