Evidence map›Paper›PMID 41165597›Full record

Observational studyInternational journal for quality in health care : journal of the International Society for Quality in Health Care2025

Impact of a clinical encounter time protection program on pain management: a retrospective difference-in-difference study.

Clement P Buclin, Denis Mongin, Nils Bürgisser, Amandine Berner, Pauline Darbellay Farhoumand, Jean-Luc Reny, Thomas Agoritsas, Delphine S Courvoisier

Abstract readObservational Study
In one paragraph

Observational study in International journal for quality in health care : journal of the International Society for Quality in Health Care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Clement P BuclinDivision of General Internal Medicine, University Hospitals of Geneva, Geneva, Switzerland.
Denis MonginFaculty of Medicine, University of Geneva, Geneva, Switzerland.
Nils BürgisserDivision of General Internal Medicine, University Hospitals of Geneva, Geneva, Switzerland.
Amandine BernerDivision of General Internal Medicine, University Hospitals of Geneva, Geneva, Switzerland.
Pauline Darbellay FarhoumandDivision of General Internal Medicine, University Hospitals of Geneva, Geneva, Switzerland.
Jean-Luc RenyDivision of General Internal Medicine, University Hospitals of Geneva, Geneva, Switzerland.
Thomas AgoritsasDivision of General Internal Medicine, University Hospitals of Geneva, Geneva, Switzerland.
Delphine S CourvoisierFaculty of Medicine, University of Geneva, Geneva, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatient-centred care is a cornerstone for healthcare quality, leading many hospitals to implement programs that prioritize patient, even within time-constrained clinical environments. Effects of these programs are poorly evaluated.

methodsThis retrospective observational cohort study aims to evaluate the impact of a patient-centred initiative aimed at protecting clinical encounter time by enhancing communication, fostering shared decision-making, and minimizing care interruptions on the quality of pain management in hospitalized patients. Electronic health record data and a difference-in-differences estimator were used to examine changes in quality of pain management outcomes in over 15 000 patients across 80 000 hospital stays ranging from 2018 to 2022 in the University Hospitals of Geneva, Switzerland.Pain management quality was evaluated using timeliness of pain relief delivery, adequacy of pain documentation, and patient satisfaction with pain management. Data were compared in units who implemented the programs compared to matched control units to evaluate both the immediate and sustained effects of the program, accounting for potential selection and contamination biases.

resultsThe results demonstrated significant and sustained improvements in pain management quality in intervention units. Rates of timely painkiller administration increased significantly more in intervention units compared to control units (OR: 1.46, 95% CI: [1.37, 1.56]), with effects persisting over time. Pain documentation also showed significant improvement in intervention units (OR: 1.47, 95% CI: [1.15, 1.88]), although a minor initial decline was observed, likely due to temporary staffing disruptions during implementation. However, there was no significant improvement in patient-reported satisfaction with pain management, which may reflect limitations in survey sensitivity and response biases given the 53.3% response rate.

conclusionThis patient-centred program effectively improved objective measures of pain management quality in a tertiary hospital setting. However, further research is needed to assess its impact on patient experience, as well as healthcare professional engagement and satisfaction. Insights from future studies could guide the development of similar patient-centred initiatives that aim to balance efficiency with high-quality patient care.

Indexed as

Pain ManagementPatient-Centered CareAdultAgedCommunicationDecision Making, SharedElectronic Health RecordsFemaleHumansMaleMiddle AgedPatient SatisfactionQuality of Health CareRetrospective StudiesSwitzerlandTime Factorsaccessevaluationhealth carehealth care qualityimplementation sciencequality indicators

Identifiers

PMID41165597
PMCPMC12602149

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.