Hospitals limit opioid prescriptions

UTICA, N.Y. >> Surgeons from 18 upstate New York hospitals and health centers, including four hospitals in the Utica/Rome/ North Country region, are collaborating with each other and with Excellus BlueCross BlueShield to reduce the number of unnecessary opioid pills prescribed when patients are discharged from the hospital following any of 21 different surgical procedures.

The goal is to lower the risk of opioid misuse by reducing the number of opiate medications prescribed through a collaborative approach that blends the experience of surgeons and their hospitals with the data analytics of Excellus BCBS. The guidelines established by the surgeons themselves will help to ensure that patients can adequately control their pain in the postoperative period.

“We’re honored to play a convening role with our surgeon partners to help them identify best practices, establish prescribing guidelines and periodically review data we collect for them so they can analyze and share their experiences with one another,” said Dr. LouAnne Giangreco, vice president and chief medical officer for health care improvement at Excellus BCBS. “This approach helps us achieve our mission, which is to collaborate with doctors in order to improve care for our members and our communities.”

The surgical quality initiative on opioid prescriptions began in 2018 when surgeons and nurses from 18 hospitals got together with the health plan to address the problems of opioid dependency and abuse.

The surgeons reviewed best practices and reached consensus on appropriate opioid levels to prescribe for patients who have undergone any of 21 different procedures, which range from more intensive total knee replacement surgery to incision-less surgery for bladder tumors.

“The idea was for the surgeons and Excellus BCBS to develop some baseline data on those surgeries, and for the surgeons to set goals that move discharge prescriptions to the agreed-upon best practice levels over time,” said Giangreco. This month marks the beginning of the new measurement period when the health care providers will be able to analyze, compare and demonstrate improvement.

Participating hospitals with surgeon champions in the program include:

Utica/Rome/North Country Region

• A.O. Fox Hospital • Bassett Medical Center • Samaritan Medical Center

• St. Elizabeth Medical Center

Central New York Region

• Oswego Hospital • St. Joseph’s Health Hospital

•SUN Y Up state Medical University (2 sites)

Western New York Region

• Erie County Medical Center (ECMC) • Kaleida Health (2 sites) • United Memorial Medical Center (Batavia)

Finger Lakes Region

• Clifton Springs Hospital • Highland Hospital • Newark-Wayne Community Hospital

• Rochester General Hospital

• Strong Memorial Hospital

• Unity Hospital

Southern Tier Region

• Our Lady of Lourdes Memorial Hospital

• United Health Services Hospitals (1 site)

Surgeries that are part of the program include:

• Total knee replacement

• Lumbar laminectomy • Total hip replacement • Cervical arthroplasty/ discectomy/fusion

• Lumbar microdiscectomy • Rotator cuff repair • Panniculectomy • Total abdominal hysterectomy • Breast reduction • Laparoscopic cholecystectomy

• Laparoscopic vaginal hysterectomy • Inguinal hernia repair • Laparoscopic nephrectomy

• Laparoscopic gastric bypass

• Laparoscopic gastric sleeve

• Carotid endarterectomy

• Mitral valve replacement

• VNUS closure (varicose vein treatment)

• Transurethral Resection of the Bladder Tumor (TURBT)

• Endoscopic sinus surgery

• Coronary Artery Bypass Grafting (CABG)

The goal is to lower the risk of opioidmisuse by reducing the number of opiate medications prescribed through a collaborative approach that blends the experience of surgeons and their hospitalswith the data analytics of Excellus BCBS.