HRET HIIN ADVERSE DRUG EVENTS (ADE)

Transcription

1 HRET HIIN ADVERSE DRUG EVENTS (ADE) Adjuncts and Alternatives to Opioids for Pain: It s All About Love February 14,

2 Shereen Shojaat, MS, Program Manager HRET WELCOME AND INTRODUCTIONS 2

3 Agenda 12:00-12:05 p.m. Welcome and Introductions Open and housekeeping information, including review of relevant HRET HIIN resources and LISTSERV. Shereen Shojaat, MS Program Manager, HRET 12:05-12:10 p.m. HIIN Data Update Review current ADE measure rates. 12:10-12:25 p.m. PFE: The Family as a Resource to Prevent Oversedation From tragedy to resource, learn how caregivers can add family to the team, and how family can assist in preventing opioid harm. 12:25-12:30 p.m. Comfort Menus and Integrative Health For pain management opioids and non-opioids have been the staple. How else can we reduce the need for opioids: Dogs? Massages? Music? Hot Tea? Is anybody really doing any of this? Paul Cholod Data Analyst, HRET Laura Townsend Louise H. Batz Patient Safety Foundation Steve Tremain, MD, FACPE Maryanne Whitney, RN, CNS, MSN Cynosure Health Improvement Advisors 12:30-12:45 p.m. Hospital Panel Discussion: Comfort Menus Join a lively discussion about these new modalities and learn how they can be incorporated as options in your toolbox for managing pain. 12:45-12:50 p.m. Next Steps Discuss next steps and action items. 4 Attendees (Open lines) Shereen Shojaat, MS Program Manager, HRET

4 Paul Cholod, Data Analyst HRET HIIN DATA UPDATE 5

5 Adverse Drug Events- Baseline Data Results Measure Description Rate Nbr Hosps Reporting Nbr Hosps Expected Submission Rate ADEs-excessive anticoagulation ,600 61% ADEs-hypoglycemia ,600 59% ADEs-opioids ,600 60% 6

6 Steve Tremain, MD, FACPE, Improvement Advisor Cynosure Health OPIOID SAFETY: WHERE WE HAVE BEEN, WHERE WE ARE GOING 7

7 Our journey since HEN 1.0 Education on: Risk screening- Opioid Knowledge Assessment available here. Opioid safety strategies virtual event available here. Dosing, limits, and morphine equivalence virtual event available here. Non-opioid pharmacologic alternatives virtual event available here. 8

8 Untapped Resources The family at the bedside as a member of the opioid safety team Non pharmacologic treatment modalities Should the focus be on pain or comfort? Modalities that can reduce anxiety Anxiety reduction as a path to pain reduction 9

9 Laura Batz Townsend Louise H. Batz Patient Safety Foundation PFE: THE FAMILY AS A RESOURCE TO PREVENT OPIOID OVERSEDATION 10

10 The Mission of the Louise H. Batz Patient Safety Foundation is to help prevent medical errors by ensuring patients and families have the knowledge they need to promote a safe hospital experience for their loved ones, and to support innovative advancements in patient safety.

11 My Mom

12 My Mom s Story 1. Lack of Teamwork She had a great doctor, great nurse, and a great family. But great players don t make a great TEAM. 2. Lack of Knowledge The family and the patient didn t have the tools they needed to become an informed active member of the team. We asked tons of questions we just didn t get LUCKY and ask the right one. 3. Lack of Technology The only machines she was hooked up to was the PCA therapy machine, she had no Oxygen or Heart monitors on her at all. The hospital standard of care was to come check on her every four hours.

13 Strong Medical and Community Partnerships Support a multidisciplinary team to develop and implement new and proven safety measures and technology that will improve patient safety. The team includes medical doctors, nurses, hospital administrators, pharmacists, and community representatives

14 Online Resources and Community Outreach Create resources to help patients and families answer questions before going into the hospital, while in the hospital, and after going home from the hospital. Currently our material can be found in book and app form. We offer guides for adults, pediatric care, and pediatric transplant care. Guides come in English, Spanish, and Dutch. Apps can be used in the hospital or for routine and ongoing care, are free and can be used on all ios and android tablets and phones.

15 Education Louise H. Batz Patient Safety Guide for Bedside Advocacy Developed and validated by 14 leading physicians and nurses. Over 70 pages of tips work sheets and tools to help patients and families involved in their own hospital care. Designed to encourage patients to ask potentially life-saving questions in a language that they and their medical teams can all understand.

16 The Batz Patient Guide App

17 The Batz Guide

18 Process Work Flow

19 Partnership Opportunities

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21 Steven Tremain, MD, FACPE and Maryanne Whitney, RN, CNS, MSN Improvement Advisors Cynosure Health COMFORT MENUS AND INTEGRATIVE HEALTH USING NON-PHARMACOLOGICAL TACTICS TO SUPPORT THE PATIENT S PAIN EXPERIENCE 22

22 CAN WE MANAGE PAIN WITH NON- PHARMACOLOGIC METHODS? What do we do at home? Comfort measures: Pet therapy Warm compresses, blankets Ice packs Extra pillows Aromatherapy Massage Herbal tea Stress ball Music 23

23 DO COMFORT ITEMS HELP? These modalities can: Reduce anxiety Reduce pain Reducing anxiety can reduce pain Non-pharmacologic pain reduction methods reduce the need for pain medications 24

24 DO HOSPITALS OFFER THESE? / 25

25 DO HOSPITALS OFFER THESE? rvices/pain-control-comfort-menu.html 26

26 POSITIVE RESULTS Pain scores Nausea scores Anxiety scores. All decreased by more than 50 percent NEXT: Looking to see if opioid usage and opioid ADEs are both decreased. 27

27 PUTTING IT ALL TOGETHER Emma, age 13, had her 3 rd surgery for a congenital foot deformity. Pain management was problematic, so both gabapentin and pet therapy were added to lower opioid doses with excellent results, allowing discharge to home 36 hours later. 28

28 CASE STUDY 29

29 ALL DISCUSSION, REACTION, YOUR IDEAS! 30

30 Shereen Shojaat, MS, Program Manager HRET NEXT STEPS 31

31 ADE Resources Change Package 2017 ADE Change Package COMING SOON 32

32 ADE Resources - Checklist 33

33 ADE Resources - LISTSERV Join the LISTSERV Ask questions Share best practices, tools and resources Learn from subject matter experts Receive follow-up from this event and notice of future events 34

34 Thank You! Find more information on our website: Questions or Comments: 35