CalvertHealth Wins Quality Innovator Award for Opioid Stewardship
CalvertHealth (Prince Frederick, MD) was recently named Health Quality Innovator of the Year for 2017, for their collaborative Opioid Stewardship Program. The organization was one of eight recognized across Maryland and Virginia for implementing quality improvement strategies that align with the Triple Aim: better care, better population health, and lower costs.
According to Calvert’s Director of Pharmacy Kara Harrer, the organization has taken a collaborative approach to reducing opioid use, forming a multidisciplinary opioid stewardship team that includes physicians, nurses, pharmacists, social workers, urgent care and ED staff. One of the major goals of their program was to educate ED physicians and staff on when to prescribe opioids for pain management, and what constitutes appropriate dosing.
“Restricting access to opioids and relying more on alternatives has been key to our strategy,” Harrer said. “For example, dilaudid is seven times more potent than morphine. We started our dilaudid-free ED initiative last year, which means that we stopped using it as a first line med, and only keep one or two doses in our dispensing cabinet - for those hospice or cancer patients whose pain cannot be controlled any other way. For many patients, we can choose something safer.”
The clinical decision support built into Calvert’s EHR has also reinforced their efforts to move away from unnecessary opioid prescribing.
“Our order sets are in sync with CDC guidelines, and designed to discourage high dosing,” Harrer said. “Our providers were also given new prescribing guidelines and educational materials on opioid safety. Instead of giving a patient 60 percocets, we might prescribe 15 and recommend Tylenol thereafter. We’ve made sure both clinicians and patients are aware of why we are doing this.”
As a result, Calvert’s opioid stewardship program has exceeded their initial goals. “We were hoping to reduce opioid prescriptions in the ED by 20% in the first year of our program, but it decreased by 26% in just the first six months,” she said. “Overall, we’ve seen a 94% decline in our dilaudid use, and a 46% decrease in our use of other opioids, such as oxycontin.”
For organizations looking to decrease their opioid use, Harrer recommends choosing one area of improvement and building up gradually. “Don’t try to tackle all of your problems at once - pick one area to work on, and your solutions will start to trickle down,” she said.
“After seeing our success in the ED with dilaudid and staff education, our community providers were very impressed. There has been no pushback. That, and recognition like the Innovator of the Year award, is building up our confidence to start making changes in other areas, like surgery and dental prescriptions. Even small changes can be enough to touch one family, or save a life.”
Learn more about how MEDITECH customers are fighting the opioid epidemic in our Opioid Crisis Special Report.