of opioid overdose. In 2017 alone, more than
as a result of opioid overdose, including prescription opioids, heroin, and fentanyl, a powerful synthetic opioid. The numbers are astronomical, enough for the President to declare opioids a
. The brunt of the epidemic is not just felt by those who succumb to opiates, but also by family, friends and the communities that HCA Healthcare serves.
The importance of take back events
Facilities across the HCA Healthcare network lie in states heavily impacted by the opioid crisis. Caregivers know the scourge of opioid misuse, addiction and overdose. “Every day, hospitals across the country treat patients for opioid overdose in emergency rooms,” said Dr. Michael Schlosser, vice president of clinical excellence and surgical services at HCA Healthcare.
“Take back events are vital to helping prevent drug overdose, controlling illicit drug use and curbing our nation’s opioid crisis,” says Schlosser.
More than
half of people who misuse opioid medications report:
- Obtaining them for free or stealing them from someone they know
- Going to multiple doctors to get additional prescriptions
- Filling prescriptions at different pharmacies so that no one will notice how many pills they get each month.
Teens hold a common misperception that prescription drugs are less harmful than other drugs; in the past year,
two-thirds of teens who misused pain relievers reported that they got them from family, friends and the home medicine cabinet.
The safest and most responsible option to dispose of medication is to take unwanted medications to a drug take back site or event. Unused opioids thrown in the trash can be retrieved and abused or sold illegally. Flushing medications down the toilet pose a potentially health and environmental hazard.
What HCA Healthcare is doing
“Crush the Crisis” opioid take back events are just one spot, among many, in HCA Healthcare’s dedication to curbing opioid misuse. Watch:
Harnessing scale and resources
In 2018, HCA Healthcare’s
TriStar Health Division, headquartered in Nashville, hosted the first “Crush the Crisis” event. More than 224 pounds of medication, equivalent to over 100,000 doses, were anonymously collected across eight hospitals.
“We were excited about the success of our TriStar Health Division’s take back day last year and knew that with HCA Healthcare’s scale, we could make an even greater impact by expanding this program to more of the communities we serve,” said Dr. Schlosser.
In addition to “Crush the Crisis” take back events, approximately 11 HCA Healthcare affiliated hospitals nationwide will launch permanent medication collection boxes.
Partnership is key
HCA Healthcare proudly partners with the National Academy of Medicine(NAM)’s Action Collaborative on Countering the U.S. Opioid Epidemic, consisting of more than 50 organizations that share best practices and identify gaps in the safe treatment of opioid addiction.
HCA Healthcare has committed $500,000 to the Collaborative to support development of safer pain management protocols and reversal of the opioid crisis.
NAM president, Dr. Victor Dzau, Assistant HHS Secretary Dr. Brett Giroir, Dr. Ruth Katz and HCA Healthcare’s president of clinical services and chief medical officer, Dr. Jonathan Perlin, serve as co-chairs for the Collaborative to combat over-prescription of opioids, improve provider education, and address under-treatment of opioid use disorders.
Dr. Mike Schlosser serves on the NAM “Opioid Prescribing Guidelines and Evidence Standards” committee, which is synthesizing evidence-based practices, establishing a clearinghouse for best practices and identifying gaps in research for safe treatment of opioid addiction.
New strategies for pain management
HCA Healthcare developed new strategies to manage pain for the 1.5 million patients that have surgery annually in an HCA Healthcare facility. HCA Healthcare’s Enhanced Surgical Recovery (ESR) is an innovative surgical approach that uses evidence-based pre, intra, and post-operative interventions to optimize patient outcomes.
ESR, which features a multi-modal approach to pain management for patients, has demonstrated significant improvements in surgical recovery and – importantly – a drastic reduction in the use for opioids.
Multi-modal pain management, focuses on using two or more different methods or medications to manage pain and reduces the need to use opioids to manage a patient’s pain while recovering from surgery. This approach results in significantly decreased opioid use and opioid prescriptions.
HCA Healthcare data from January 2018 through June 2019, collected from 47,400 major abdominal, joint, gynecologic oncology, spinal and bariatric ESR surgeries revealed an up to 50.4% decrease in opioid use for these patients.
The data, collected from 114 affiliate hospitals, was compared to a non-ESR protocol patient population undergoing the same surgery procedures in the same time period.
As of June 2019, ESR is live at 127 HCA Healthcare facilities, with the goal to implement in all facilities for at least one major service line by the end of 2019.
With ALTO in the ER, HCA Healthcare’s goal is to manage painful conditions for emergency department patients and return them to a maximum quality of life, while recognizing and reducing the inherent risks of administering and prescribing highly addictive medications like opioids.
In 2017, affiliate
Swedish Medical Center pioneered the first-of-its-kind strategy to curtail potential opioid misuse related to the use of opioids in the emergency department.
With the ALTO in the ER program, rather than using opioids like oxycodone, hydrocodone or fentanyl, medications like ketamine and lidocaine are employed for frontline pain management.
Because of this emergency department initiative, patient opioid use at affiliate Swedish Medical Center from June – November of 2017 was reduced by 36%, compared to data from a non-ALTO patient population over the same time period in 2016.
HCA Healthcare plans to expand the ALTO in the ER protocols enterprise-wide in 2019.
Electronic prescribing of controlled substances (EPCS)
Electronic prescribing of controlled substances (EPCS) aims to stem increasing rates of opioid-related addiction, misuse diversion and death by making it more difficult for medication-seekers to doctor-shop and alter prescriptions. Physicians have access to aggregated electronic health record (EHR) data that will help them to prescribe opioids judiciously.
ECPS allows clinicians to see patients’ medication histories at the point of care, which helps identify patients who may be exhibiting behaviors associated with drug misuse. ECPS also ensures that prescriptions are securely transmitted from clinician to pharmacy without risk for forgery or alteration. As of June 2019, more than 2,800 physicians across HCA Healthcare have EPCS.
HCA Healthcare is comprised of 184 hospitals and approximately 2,000 sites of care, including surgery centers, freestanding ERs, urgent care centers, and physician clinics, in 21 states and the United Kingdom. With its founding in 1968, HCA Healthcare created a new model for hospital care in the United States, using combined resources to strengthen hospitals, deliver patient-focused care and improve the practice of medicine.
