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A Health System-Wide Initiative to Decrease Opioid-Related Morbidity and Mortality.
- Source :
-
Joint Commission journal on quality and patient safety [Jt Comm J Qual Patient Saf] 2019 Jan; Vol. 45 (1), pp. 3-13. Date of Electronic Publication: 2018 Aug 28. - Publication Year :
- 2019
-
Abstract
- Background: 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.<br />Methods: 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.<br />Results: 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; p < 0.001), mean morphine milligram equivalents (MME) per prescription decreased (-0.4/month; p < 0.001), the number of unique patients receiving an opioid decreased (-52.6/month; p < 0.001), and the number of prescriptions ≥ 90 MME decreased (-48.1/month; p < 0.001). Prescriptions and providers for buprenorphine increased (+6.0 prescriptions/month and +0.4 providers/month; both p < 0.001). Visits for opioid overdose did not change (-0.2 overdoses/month; p = 0.29).<br />Conclusion: 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.<br /> (Copyright © 2018 The Joint Commission. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Advisory Committees organization & administration
Humans
Information Systems organization & administration
Inservice Training
Practice Guidelines as Topic
Practice Patterns, Physicians'
Program Evaluation
Quality Improvement organization & administration
United States
Analgesics, Opioid administration & dosage
Drug Utilization standards
Hospital Administration
Opioid-Related Disorders prevention & control
Subjects
Details
- Language :
- English
- ISSN :
- 1553-7250
- Volume :
- 45
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Joint Commission journal on quality and patient safety
- Publication Type :
- Academic Journal
- Accession number :
- 30166254
- Full Text :
- https://doi.org/10.1016/j.jcjq.2018.07.003