Georgia Hospital Engagement Network
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Transcript of Georgia Hospital Engagement Network
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Georgia Hospital Engagement Network
Hospital Acquired Condition Affinity Webinar Series
3/19/2014
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Dr. Roy Soto
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Dr. Soto is an anesthesiologist at William Beaumont Hospital in Royal Oak Michigan. Following his residency training at UCLA, he joined the faculty of the University of South Florida in Tampa, and then the State University of New York at Stony Brook. In 2007 he was recruited to Beaumont Hospital to start an anesthesiology training program, and he currently is the Residency Program Director. He also serves as a Professor of Anesthesiology at the hospital's affiliated medical school, and his research interests include patient safety, enhanced recovery after surgery, care standardization, and service excellence/patient satisfaction
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Re-evaluating Safe Perioperative Pain Management
National Procedural NO Harm Affinity Group
Roy Soto, M.D.
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Case Presentation
• 52yo s/p posterior cervical fusion• BMI 34
• OR pain meds: 0.5mg hydromorphone• PACU pain meds: 2.5mg hydromorphone
• Hospital course: dead within 2hr of arrival on ward
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Overview
• Assumptions• MHA pain management toolkit• MHA data measures
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0
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Any Pain Slight Moderate Severe Extreme
Pate
ints
(%)
1993 1999 2012
6
Pain is Poorly Controlled
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2001
2012
Opioids Cause Harm
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Hospital X
Pain Control Drives Satisfaction
HCAHPS/Hospital Compare
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Pain Control Enhances Recovery
• ↓opioids/↑multimodal analgesia leads to– Earlier return of gut motility– Earlier enteral feedings– Earlier mobilization– Earlier removal of drains/catheters
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Implementation
• Baseline data collection– Gap analysis– Outcome and process data
• Implementation of MOSS tool• Education
– Physician– Nursing– Patient
• Reassessment and refinement
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Implementation
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Implementation
Patient Education
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Gap Analysis Tool
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Michigan Opioid Safety Score
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Process & Outcome Measures
A. MHA Derived measures (numerator/denominator)1. % pts readmitted within 30d/total number surg proc2. HCAHPS q13
B. Process Measures (numerator/denominator)3. # surg pts receiving opioids/total number surg proc4. # pts eval with MOSS/total number surg proc
C. Outcome Measures(numerator/denominator)5. # surg pts rec Narcan/# surg pts receiving opioids6. # RRT opioid calls/# surg pts receiving opioids
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Process & Outcome Measures
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Educational Product
• Powerpoint with voiceover– Surgeon– Anesthesia– Nursing
• Live presentations• +/- CME/CE• Patient print product
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Dynamic Processes
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Contact Information
• Michelle Norcross, MSA – Michigan Health & Hospital Association Keystone
Center Project Manager– 517-886-8357– [email protected]
• Roy Soto, MD– Beaumont Health System– [email protected]