Procedural Pain Management

Background

Chronic pain management is an evolving and complex multi-specialty practice. As the use of interventional pain procedures for the management of chronic pain has expanded, hospital wait lists for these procedures have grown. Increasingly, procedural pain management (PPM) is being provided in private clinics and physician offices, but without much guidance on appropriate credentials, settings, techniques and equipment. This can create significant risk of harm to patients.

Recognizing these risks, the College announced in 2016 an initiative to develop standards for the accreditation of PPM procedures performed in community-based physician offices, practices and clinics. Following input from a variety of expert stakeholders, the College has developed draft accreditation standards for public feedback. These standards address:
  • the PPM procedures that may only be performed in an accredited facility, 
  • the requirements for imaging (ultrasound, fluoroscopy, CT), 
  • the requirements for infection, prevention and control, and 
  • the requirements for patient safety and quality care.

The process for developing these standards included convening an advisory panel of subject-matter experts in pain medicine, anesthesiology (including family practice anesthesia), interventional radiology and physical medicine and rehabilitation.

In parallel was the BC Medical Quality Initiative’s development of a new privileging dictionary for PPM which categorizes such procedures, using a tiered approach, from Basic to Advanced II. There has also been discussion with the Ministry of Health, including the provincial chronic pain strategy group, health authorities and front-line care providers regarding the impact of this quality and safety initiative.

Provide feedback

The College is inviting your feedback on the new PPM accreditation standards. Four draft standards are available for review:
Participate in the consultation here until May 27, 2019.

Next steps

Once consultation is complete and the standards are approved by the Non-Hospital Medical and Surgical Facilities Accreditation Program Committee, the implementation plan will allow time for physicians, offices, practices and clinics to transition intermediate and advanced PPM procedures to the appropriate setting as needed.
 
The College recognizes that initially there may be a perceived loss of access by patients during this transition to safer and high-quality care. By ensuring the right provider, the right imaging, and the right setting through the accreditation of PPM procedures performed in the community-based setting, the College can ensure patients will receive safe and appropriate care.
 
Thank you for sharing your input.