New York City-based NYU Langone Orthopedic Hospital’s Associate Program Director of The Center for Quality and Patient Safety Lorraine Hutzler shared the details behind the hospital's opioid prescribing program and how it cut prescribing drastically.
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Question: What's something you've implemented at your center that has seen great results that other ASCs could benefit from?
Lorraine Hutzler: We have been conducting an initiative in regards to the opioid epidemic. We pulled prescribing data for each of our physicians as well as by procedure type. Then we shared this information with each of our divisions. We had them come up with designated guidelines on the appropriate amount of pills to be prescribed by procedure type, level of pain and [for patients with] any preexisting opioid use. For those patients who have had previous issues, or it seems like there will be an issue we make sure are given extra assistance through either pain management consults or a meeting for alternative pain management therapies.
Not [only has there been] less opioid use, but fewer prescriptions are being written by physicians and the amounts prescribed [by physician] have become more consistent. When we initially looked at the data, we were looking at one specific procedure type, like anterior cruciate ligament repair or rotator cuff repair, then we'd [compare prescribing patterns] for two different surgeons for each procedure. One could have prescribed five pills and the other could have prescribed 50; there wasn't consistency among the procedures. So that's why we developed protocols and implemented new guidelines to make a designated dosage recommendation by type of procedure.
[This could be done at any practice]. You really need buy-in from the orthopedic surgeons, they need to understand the whole epidemic and how orthopedics contributes to it. Orthopedics has the third highest prescribing rate for all physicians, but we can do something about it.
Have an idea that's worked well at your surgery center? Send it to Eric Oliver at eoliver@beckershealthcare.com.