It’s no secret that massage, exercise, music, and aromatherapy can improve the lives of people who suffer chronic pain. But how can nursing homes best use those nonpharmacological treatments in pain management?

This was the question Associate Professor of Medicine and Community Health David Gifford set out to answer in a two-year study initiated by seven of the largest U.S. nursing home corporations and funded by Medicaid and Medicare. Instead of dictating which treatments to use, the study gave staff the tools to implement their own approach to pain management. The number of patients experiencing pain dropped 40 percent in participating nursing homes. “The creativity and changes that came out of these teams of certified nursing assistants was wonderful,” says Gifford, who is the chief medical officer at Quality Partners of Rhode Island.

The seven companies involved are competitors, but their willingness to share information and work together to improve care impressed Gifford. “They really put the residents first,” he says. “And they’ve started taking some of the principles we’re talking about—empowering direct-care staff to solve problems rather than employing an autocratic, top-down approach—and applying them to other [areas] within the corporations.”