Introduction
CalvertHealth recognized a need for action when Calvert was identified as a high prescribing area of Maryland. Between 2010 and 2015 Calvert ranked highest in MME (Morphine Milligram Equivalence) per person. This set in motion the development of an opioid stewardship committee. The goals of the committee included strengthening safety practices for prescribing, reducing opioid use by 20% within the first ear, and enhancing opportunities for people with opioid use disorders.
Intervention
In order to see a decrease in opioid prescribing Calverthealth began by optimizing use of the EHR to ensure best prescribing practices. CRISP (Chesapeake Regional Information System) is the PDMP program used statewide. Notes about prescriptions were available to providers which assisted with providers having a comprehensive view of their patients’ needs. The EHR also recorded whether CRISP searches were performed before prescribing.
Calverthealth also educated providers on best practices for prescribing. Calverthealth decided to focus on the emergency department of the hospital as a starting point for the program however they also expanded the program to include inpatient care. Engaging the community was a key component of the program as well. Resources were created for the public in order to create knowledge and awareness of Calverthealth’s goals.
Results
Calverthealth was able to see a 26% reduction in total opioid orders in the emergency department. There was a 46% reduction in total tablet opioid orders in the ED. Patient satisfaction did not decrease due to new prescribing habits.