Impact of a clinical encounter time protection program on pain management: a retrospective difference-in-difference study
Bibliographic record
Abstract
BACKGROUND: Patient-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. METHODS: This 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. RESULTS: The 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. CONCLUSION: This 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.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.018 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".