Purpose: The purpose of this article is to describe barriers to cancer pain management and strategies for making improvements in an academic rural cancer center.
Overview: Rural communities pose unique challenges to cancer pain management because of their unique strengths and burdens. Successful strategies used by a comprehensive cancer center to improve pain management in rural New England are summarized.
Clinical implications: Improving cancer pain management in a rural setting required a recognition of the contrasting characteristics between a sophisticated academic medical center and a rural community. The successful implementation of quality improvement strategies required a combination of leadership support, internal and external funding, and professional and federal recognition of the problem. Using a quality improvement approach rather than a traditional didactic approach, and fostering communication, trust, and collegiality at our outreach sites were pivotal to our success.