Health System Clinicians Create Task Force to Reduce Opioid Prescriptions
Michael Ayers, MD and Leslie Stenbeck, RN, of South Shore Orthopedics sensed an alarming trend in their hometown of Scituate and standing by was not an option.
Stenbeck and Dr. Ayers had discovered that some athletes in the South Shore town had become addicted to pain medication after being prescribed a large quantity of pills following surgery related to sports injuries. It didn't take long for these athletes to move on to heroin, the cheaper high.
"It became apparent to us that we were prescribing medication and patients weren't taking all of it," Dr. Ayers said. "The medication was just sitting in medicine cabinets and that's where people were finding the supply of illicit narcotics to feed this continued problem."
In November of 2015, the Health Provider Services Organization (HPSO), charged with leading clinical intergration efforts, formed the Opioid Task Force, which includes providers and nurses from several surgical specialties, to reduce the number of opioid pills prescribed post-procedure.
Within three-to-four months of developing the Opioid Task Force, several groups within South Shore Health System joined the initiative and began implementing new prescribing standards.
To date, members of the task force have reduced the number of pills prescribed by 20 – 56% —depending on the procedure — across a variety of specialties, including Orthopedics, Urology, Thoracic Surgery, General Surgery, Breast Surgery, Neurosurgery and Obstetrics & Gynecology.
“The way that the specialties across the medical staff have so quickly jumped onto this task force to do this work has really surprised me," said Luke O’Connell, MD, chair of HPSO and the Opioid Task Force. "Everybody understands what a crisis we’re in now and wants to do the right thing and do all we can to address the problem.”
The participating providers have been surveying their patients at their two week post-op appointment to find out how many pills they are actually taking and weighing that quantity against the number of pills that were dispensed to them. Many providers were prescribing 30 or more pills but most patients were taking only zero-to-five. This means that quite a bit of unused pain medication is sitting in medicine cabinets to serve as bait for anyone that is drug seeking.
The work of the task force continues to evolve and over time the goal is to get more specialties within South Shore Health System involved. The long-term goal is to assist other providers with creating their own set of standards and prescribing practices.
"We've got a lot of work to do. All of society needs to change the way we look at (opioid prescribing)," said Dr. Janet Limke, medical director of The Spine Center at South Shore Hospital’s Center for Orthopedics, Spine and Sports Medicine. "Patients need to understand that we do care about their pain and that we want to help manage their pain, but we have to find safe ways to do it."