Outpatient Surgery Magazine

Special Edition: Opioids - January 2020 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

Issue link: http://magazine.outpatientsurgery.net/i/1198986

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Page 45 of 58

more as needed." While patients do still go home with some opioids, the numbers are way down since Keck Medicine implemented its opioid-reducing pro- tocols. For example, ENT patients are prescribed 5 to 10 pills instead of the 20 to 30 pills they used to receive. Changing the strength of the opioids you do prescribe can also help prevent abuse. "We stopped giving patients oxycodone and hydrocodone after surgery, and instead use tramadol, which has fewer morphine milligram equivalents," says Dr. Dickerson. Dr. Luke suggests standardizing pain medication orders and post-op prescribing protocols, and communicating their importance to every member of the clinical team, with a particular focus on reaching sur- geons. "Surgeons might have different types of surgical techniques and disagree on how they prefer to manage patients," he says, "but they should all follow standardized pain management protocols." Little by little The road to using fewer opioids is paved with tiny victories. "If the thought of rolling out an opioid-reduction protocol seems too daunting a task for your facility, take it one step at a time," says Dr. Kim. "Once you start achieving small opioid-sparing victories, then you'll have the footing to be more aggressive in implementing the entire program." Opioid-reduction doesn't have to be an all-or-nothing proposition, points out Dr. Kim. If you aren't yet using blocks, consider implementing them. If you haven't been giving patients round-the-clock Tylenol to com- bat post-op pain, start doing that. Begin having detailed discussions about right-sizing or limiting opioid prescriptions with your surgeons and make early patient education a cornerstone of your surgical process. "When you do, you'll see progress," says Dr. Kim. "Start small and let the program gain momentum organically." OSM 4 6 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J A N U A R Y 2 0 2 0

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