Implementation of an acute pain nurse role and the expansion of the Acute Pain Service (APS) at a newly merged Canadian hospital system led to an evaluation of these programs. A literature review of APSs showed that the services with an APS nurse had improved patient outcomes. As a result, a PACU nurse was added to the APS at all hospitals, and all services were restructured. Surveys conducted one year after this reorganization showed very positive response ratings in the areas of quality of care, but mixed results in other areas including education and job satisfaction. Flow diagrams for the clinical units were developed, and both structured and informal education sessions were provided. The description of the APS nurse's role was also redefined.