A collaborative Minnesota healthcare success story
Over the course of the past three years, ICSI has convened a group of Minnesota surgeons eager to develop a more patient-centered, procedure-specific approach to postoperative opioid prescriptions. One goal was to reduce the risk for addiction among postoperative patients while still providing effective pain management by creating recommendations that could a) reduce the variation among surgeons prescribing for identical procedures and b) provide evidence-based guidance for improving postoperative opioid prescribing practices across many different surgical procedures.
The Postoperative Opioid Prescribing Initiative includes a workgroup of surgeons who gathered monthly to create new recommendations regarding the dosage and amount of opioids prescribed after surgical procedures. Recommendations were made based on the procedure, patient history, current evidence-based research and other proven practices. Changes were suggested and subsequently implemented with a specific focus on improving patient care while reaching new, lower benchmarks for opioid prescriptions.
Results
The Postoperative Opioid Prescribing Initiative has shown that by focusing on improvements one procedure at a time, significant progress can be made toward safer opioid prescribing. In fact, data from healthcare claims across the state of Minnesota demonstrates that this work has contributed immensely to safer prescribing practices including:
- A state-wide 43% decrease in the average postoperative discharge opioid dose between 2016 and 2019.
- During a four-month cohort effort significant decreases in MME prescribed for orthopedics (-45%), podiatry (-33%) and spine (-52%) surgeries.
Along with reducing the risk of addiction, patient experiences were improved by reducing pain and adverse effects of the medication.
The following document describes in detail how this unique initiative was conceived and implemented across multiple organizations. In addition, it provides specific, graphic representations of results based on claims data, and for specific surgical procedures.
This initiative proves that when healthcare providers collaborate and share best practices, the health of not only our patients, but also our communities can be improved dramatically.
“As we started the process, we worked collaboratively with systems across Minnesota to understand what each system is doing for safe opioid prescribing. This collaborative approach allowed us to understand what was working, and what could be changed. We then used that information to create opioid prescribing recommendations that factored in patients receiving medical care in a variety of settings. Working collaboratively also allowed the work group to compare how the recommendations were being implemented, and evaluate what worked best.” Katie Nixdorf, MD, Medical Dyad Lead, M Health Fairview Pain Management