Illinois Surgical Quality Improvement Collaborative
Working Together to Achieve Rapid and Sustained Improvement for Surgical Patients
Opioid Reduction Initiatives
The Problem
Over-Prescribing
Surgeons are adding to the supply and fueling the nonmedical use of narcotics.
Acute Surgical Pain
Surgery hurts but too many surgeons rely on narcotics as the only or the primary means for treating surgical pain.
Chronic Pain from Surgery
Chronic Post-Surgical Pain (CPSP) occurs in:
*Up to 7% of outpatient procedures (Alam et al., 2012)
*Up to 23% of inpatient procedures (VanDenKerkhof et al., 2012)
Poor Science
We have very little data on how surgeons are adding to the opioid epidemic, how various proposed interventions work, or even who is at highest risk for adverse drug events.
Prescribing Recommendations
ISQIC Opioid Stewardship Toolkit
The ISQIC Coordinating Center would love to hear from you about your hospital’s experience with implementing opioid stewardship initiatives. For more information related to opioid stewardship efforts, please contact us here.
Addressing Over-Prescribing
Create an opioid retrieval program
Systematic changes to default order sets
Automate prescription monitoring program inquiries
Create best practices for prescribing patterns
Physician, RN, patient education
Addressing Acute Surgical Pain
Emphasize use of non-narcotic pain treatment pathways
Develop of transition pain services
Addressing Chronic Pain from Surgery
Improve transition to PCP
Decrease use of narcotics with non-narcotic adjuncts
Improving the Science
Partner with the Illinois Prescription Monitoring Program (IL-PMP)
Partner with private and public insurers
Partner with pharmacies
Share data among hospitals (inpatient pharmacy records)
Develop physician and hospital-level reports
Measure adverse drug events
Illinois Prescription Monitoring Program and EMR Integration
Integrate your Electronic Health Record (EHR) with the Illinois Prescription Monitoring Program (IL-PMP).
New IL legislation (SB772 / Public Act 100-0564) requires all prescribers of schedule II controlled substances to register with the IL-PMP and to document attempts to access the PMP upon initially prescribing a schedule II narcotic to a patient (with a few exceptions).
IL-PMP look-up enables prescribers to review a patient’s prescription history and inform treatment and prescribing decisions. Additionally, all hospitals are required to integrate their EHRs with the IL-PMP by 2021.
ISQIC is interested in learning about your hospital’s experience with EHR integration and facilitating the sharing of best practices. For more information related to IL-PMP, please contact us here.
The Consequences
The ISQIC Solution
Resources
A list of informational links are provided and can be used as resources to help minimize opioid prescribing.
Over prescription of narcotics is common and retained surplus medication presents a readily available source of opioid diversion (Bates 2011).
1 in 20 people in the U.S. (ages 12 or older) reported using prescription painkillers for non-medical reasons in the past year (CDC Guidelines, 2016).
Nearly half a million emergency department visits in 2009 were due to people misusing or abusing prescription painkillers (CDC Guidelines, 2016).
Non-medical use of prescription painkillers costs health insurers up to $72.5 billion annually in direct health care costs (CDC Guidelines, 2016).
Rodgers, J., Cunningham, K., Fitzgerald, K., Finnerty, E. Opioid consumption following outpatient upper extremity surgery. Journal of Hand Surgery 2012; 185:2
ISQIC Opioid Webinars
Upcoming Webinars
TBA
Past Webinars
More Information
ISQIC is pleased to offer a webinar series addressing topics related to opioid stewardship in surgical care, including implementing clinic or hospital-based opioid take back, lowering default opioid prescription quantities, patient education initiatives, and more.
Is your hospital interested in sharing about your opioid stewardship initiatives with other IL hospitals? Even if your hospital is in the early stages of implementation, we would love to hear from you and have you share with the ISQIC hospitals during our webinar.
Contact us here.
Download the Opioid
Cited Literature
Download the Opioid Reduction Initiative Flyer
For inquiries regarding the Opioid Reduction Initiatives, please email the opioidreduction@isqic.org.