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Georgia Hospital Engagement Network

Georgia Hospital Engagement Network. Hospital Acquired Condition Affinity Webinar Series 3/19/2014. Dr. Roy Soto.

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Georgia Hospital Engagement Network

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  1. Georgia Hospital Engagement Network Hospital Acquired Condition Affinity Webinar Series 3/19/2014

  2. Dr. Roy Soto 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

  3. Re-evaluating Safe Perioperative Pain Management National Procedural NO Harm Affinity Group Roy Soto, M.D.

  4. 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

  5. Assumptions MHA pain management toolkit MHA data measures Overview

  6. Pain is Poorly Controlled 6

  7. Opioids Cause Harm 2001 2012

  8. Pain Control Drives Satisfaction Hospital X HCAHPS/Hospital Compare

  9. Pain Control Enhances Recovery • ↓opioids/↑multimodal analgesia leads to • Earlier return of gut motility • Earlier enteral feedings • Earlier mobilization • Earlier removal of drains/catheters

  10. Implementation • Baseline data collection • Gap analysis • Outcome and process data • Implementation of MOSS tool • Education • Physician • Nursing • Patient • Reassessment and refinement

  11. Implementation

  12. Implementation Patient Education

  13. Gap Analysis Tool

  14. Michigan Opioid Safety Score

  15. Process & Outcome Measures • MHA Derived measures (numerator/denominator) • % pts readmitted within 30d/total number surg proc • HCAHPS q13 • Process Measures (numerator/denominator) • # surg pts receiving opioids/total number surg proc • # pts eval with MOSS/total number surg proc • Outcome Measures(numerator/denominator) • # surg pts rec Narcan/# surg pts receiving opioids • # RRT opioid calls/# surg pts receiving opioids

  16. Process & Outcome Measures

  17. Educational Product • Powerpoint with voiceover • Surgeon • Anesthesia • Nursing • Live presentations • +/- CME/CE • Patient print product

  18. Dynamic Processes

  19. Contact Information • Michelle Norcross, MSA • Michigan Health & Hospital Association Keystone Center Project Manager • 517-886-8357 • mnorcross@mha.org • Roy Soto, MD • Beaumont Health System • roy.soto@beaumont.edu

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