Swedish Health Services is empowering patients and providers to better address pain and opioid management. Through a multidisciplinary pilot in Neurosurgery at Cherry Hill, Swedish is promoting judicious opioid prescribing and helping patients better understand pain management.
For the pilot, the neurosurgery specialty group took the lead among specialty provider groups with the goal of reducing prescribing variation for discharge prescriptions and increasing appropriate uptake of non-opioid pain management therapies. The three-pronged approach places equal emphasis on partnerships between providers, patients and their nursing care teams. Providers are equipped with opioid prescribing data, and guidance in translating industry recommendations into non-opioid pain management standards of care for neurosurgery patients. A key process metric was the balancing measure of the patient experience of education and pain management.
According to Sandeep Sachdeva, MD, the pilot’s executive sponsor, “Our multimodal and multi-disciplinary approach leveraged the whole care team. Providers determine the right patient specific interventions and to help set patient expectations, while nurses work to enhance patient understanding of pain and empower patients to engage in the pain management process”.
Clinical teams at Swedish also work with patients to build skills in recognizing how to manage pain with non-pharmacological, non-opioid options for pain management, or “comfort care,” while communicating pain as part of the healing process. This context moved beyond measuring pain on a scale and instead focused on function and pain management tools patients can use at home with them after their hospital stay.
Over the course of the pilot, the neurosurgery department reduced average number of opioid prescriptions exceeding acute guidelines by 31 percent, decreased average number of opioid prescriptions overall by 15 percent and reduced the average prescription supply days by ½ day. To ensure patients were well supported during the change, a patient survey on perception of pain management and education revealed 27 percentage point increase in patient readiness to manage pain at home and 30 percentage point understanding of non-opioid options.
We at WSHA are thrilled to hear of the success of Swedish’s neurosurgery specialty opioid management pilot. We are invested in supporting our members’ efforts to reduce unnecessary opioid prescribing and increase access to non-opioid pain management treatment. Recently, we launched the WSHA WSMA Opioid Prescribing Reports. The reports are a system-level snapshot of opioid prescribing behaviors by specialty group, including peer benchmarks for Washington State and reflecting prescribing to all patients. The reports are intended to equip quality leaders and chief medical officers to engage with prescribers to create system-level solutions to minimize patients’ unnecessary exposure to opioids.