A Health System-Wide Initiative to Decrease Opioid-Related Morbidity and Mortality
| Autor: | Elizabeth Harry, Erika Pabo, Shelly Anderson, Rajesh Patel, Allen Kachalia, Stanley W. Ashley, Alev J. Atalay, Christin N. Price, Joji Suzuki, Scott G. Weiner |
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| Rok vydání: | 2018 |
| Předmět: |
Program evaluation
Inservice Training Leadership and Management Advisory Committees Health administration 03 medical and health sciences 0302 clinical medicine Nursing Hospital Administration Multidisciplinary approach Medicine Humans 030212 general & internal medicine Medical prescription Practice Patterns Physicians' business.industry 030503 health policy & services Opioid overdose Opioid use disorder medicine.disease Opioid-Related Disorders Quality Improvement Drug Utilization United States Analgesics Opioid One Health Practice Guidelines as Topic Stewardship 0305 other medical science business Information Systems Program Evaluation |
| Zdroj: | Joint Commission journal on quality and patient safety. 45(1) |
| ISSN: | 1553-7250 |
| Popis: | The opioid overdose crisis now claims more than 40,000 lives in the United States every year, and many hospitals and health systems are responding with opioid-related initiatives, but how best to coordinate hospital or health system-wide strategy and approach remains a challenge.An organizational opioid stewardship program (OSP) was created to reduce opioid-related morbidity and mortality in order to provide an efficient, comprehensive, multidisciplinary approach to address the epidemic in one health system. An executive committee of hospital leaders was convened to empower and launch the program. To measure progress, metrics related to care of patients on opioids and those with opioid use disorder (OUD) were evaluated.The OSP created a holistic, health system-wide program that addressed opioid prescribing, treatment of OUD, education, and information technology tools. After implementation, the number of opioid prescriptions decreased (-73.5/month; p0.001), mean morphine milligram equivalents (MME) per prescription decreased (-0.4/month; p0.001), the number of unique patients receiving an opioid decreased (-52.6/month; p0.001), and the number of prescriptions ≥ 90 MME decreased (-48.1/month; p0.001). Prescriptions and providers for buprenorphine increased (+6.0 prescriptions/month and +0.4 providers/month; both p0.001). Visits for opioid overdose did not change (-0.2 overdoses/month; p = 0.29).This paper describes a framework for a new health system-wide OSP. Successful implementation required strong executive sponsorship, ensuring that the program is not housed in any one clinical department in the health system, creating an environment that empowers cross-disciplinary collaboration and inclusion, as well as the development of measures to guide efforts. |
| Databáze: | OpenAIRE |
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