OBJECTIVES To describe and measure intravenous patient controlled analgesia (IV-PCA) processes in postoperative pain management in patients with moderate to severe pain in clinical practice that have undergone surgery at the University Hospital Oulu Finland. METHODS A model was designed and visualized via Swimlane notation. Sub process levels were defined as “education”, “purchasing/depreciation/maintenance”, “procurement”, “supply”, “application” and “disposal”. Based on these sub process levels, data was collected by two research methods, interviews and measurement forms including patient and staff satisfaction questionnaires. RESULTS Twelve members of Oulu University Hospital personnel with different responsibilities were interviewed to define the roles and activities involved in the entire IV-PCA process. Ten different roles were defined with 151 different activities. The involved roles and the duration of each activity in the sub process levels “supply”, “application” and “disposal” were measured from 108 consecutive patients with eight different surgery types. The most common surgery types were back surgery and gynecological laparoscopy. The average duration of IV-PCA use per patient was 41 hours and 39 minutes. The staff spent on average 132 minutes in IV-PCA related activities, of which the nurse spent 91%. The average cost, including material and staff, for 24-hour usage of IV-PCA was €122. The patients found the IV-PCA system easy to operate but hindered them in mobility and they were not able to sleep unhindered. According to the staff the IV-PCA system operated error-free and reliably but hindered the mobilization of the patient. CONCLUSIONS IV-PCA involves many different roles and activities and intertwined sub processes. Therefore the whole system is complex and resource demanding. Comparisons of the results from similar studies at other hospitals will be very useful when trying to optimize the process.