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JCAHO's New Standards for Pain Management and Assessment

By AAACEUs

Joint Commission on Accreditation of Healthcare Organizations (JCAHO) New Pain Management Standards

In 2001, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) released their new pain management standards. These new standards led to a commonly held perception that pain should be seen as the "5th vital sign". At the time, patients' pain was not being managed well and the emphasis of the new guidelines was to address this concern. It is a commonly held belief that this led to a period of overprescribing that was one of the many factors that contributed to the opioid crisis.

JCAHO implemented new and revised pain assessment and management standards on January 1, 2018. Through these new standards, accredited hospitals are required to develop policies and procedures that, upon appropriate clinical determination, provide the appropriate framework to assess, treat, refer, or reassess patient pain.

These new standards reflect the need for revisions based on the opioid epidemic and the new CDC guidelines for the prescription of opioids for chronic pain.

The following are an abbreviation of the new JCAHO standards.

Accredited hospitals are required to establish policies and procedures, based on clinical determination where appropriate, that:

Establish a clinical leadership team
Actively engage medical staff and hospital leadership in improving pain assessment and management, including strategies to decrease opioid use and minimize risks associated with opioid use
Provide at least one non-pharmacological pain treatment modality
Facilitate access to prescription drug monitoring programs
Improve pain assessment by concentrating more on how pain is affecting patients' physical function
Engage patients in treatment decisions about their pain management
Address patient education and engagement, including storage and disposal of opioids to prevent these medications from being stolen or misused by others
Facilitate referral of patients addicted to opioids to treatment programs

What the new guidelines DO NOT do is:

Require the use of drugs to manage a patient's pain, nor have they ever encouraged clinicians to prescribe opioids
Endorse pain as a vital sign
Endorse the use of pain "satisfaction scores" for national, public or any other purpose other than an organization's internal quality improvement.
Require organizations to mandate that clinicians measure pain on a numerical scale or treat patients to "zero" pain.

The Joint Commission pain standards were designed to address a serious problem in patient care that affected millions of people, including inadequate pain control for both acute and chronic conditions. These standards were designed to be part of the solution to the opioid crisis in the United States.

The standards, when read thoroughly and correctly interpreted, continue to encourage organizations to establish education programs, training, policies, and procedures that improve the assessment and treatment of pain without promoting the unnecessary or inappropriate use of opioids.

More information about the new guidelines can be viewed at the following link:

Facts About Joint Commission Accreditation Standards for Health Care Organizations: Pain Assessment and Management