In 1996, 738 BUMC clinicians, representing 8 disciplines and 24 specialties, were surveyed using the Clinician Survey and Institutional Needs Assessment. This survey was developed by the Education Development Center, Inc., and distributed to 50 participating health care institutions in 21 states as part of the Mayday Pain Management Project. The BUMC findings revealed a gap between clinician knowledge and application of that knowledge to patient case scenarios. Clinician knowledge deficits included equianalgesic dosing, analgesic administration and dosing principles, nonpharmacological treatments, and assessment and management of pain in special populations. Fears and misconceptions about oversedation and drug abuse persist. Participants identified several legal and regulatory issues related to pain management, as well as improved collaboration among health care team members, as opportunities for professional growth. Based on these findings, BUMC has developed a pain management continuous quality improvement program. Efforts to identify barriers to effective pain management and attempts to modify those barriers through quality improvement programs have increased dramatically within health care organizations in recent years. Baylor University Medical Center (BUMC) is no exception. A multidisciplinary pain committee has met to collect data and address pain management issues since the early 1990s. National clinical practice guidelines for the management of acute pain and cancer pain published by the American Pain Society (APS) (1) and by the Agency for Health Care Policy and Research (AHCPR) (2, 3) have been available to health care providers for almost a decade. However, integrating these research-based guidelines into clinical practice is not a simple task. Clinicians, consumers, regulatory and accrediting bodies, and third-party payers all advocate effective, quality pain management, but barriers to relieving pain remain prevalent (2).