降低急诊医学中的阿片类药物处方率。
Reducing Opioid Prescribing Rates in Emergency Medicine.
作者信息
Guarisco Joseph, Salup Adam
机构信息
Department of Emergency Medicine, Ochsner Clinic Foundation, New Orleans, LA.
The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA.
出版信息
Ochsner J. 2018 Spring;18(1):42-45.
BACKGROUND
Pain management is one of the most common reasons patients visit the emergency department. Understanding the contributions of emergency medicine-and specifically Ochsner Health System's emergency providers-to the opioid crisis is important. Benchmark prescribing data indicated that Ochsner Health System emergency medicine providers' opioid prescription rates were significantly higher than the national average in emergency medicine.
METHODS
Data relevant to visit and opioid prescription counts were extracted from the organization's electronic health record system. Opioid prescription rates were calculated for each provider. A data transparency project was initiated in which provider opioid prescription rates were unblinded and distributed among the provider group.
RESULTS
Opioid prescription rates declined in aggregate for the emergency services from 22% to 14% during the 1-year project timeline. Some physicians demonstrated a 70% reduction in prescription rates. Importantly, patient satisfaction scores were not negatively impacted by declining opioid prescription rates.
CONCLUSION
Provider performance transparency using unblinded and transparent data analytics can efficiently and significantly alter provider practice.
背景
疼痛管理是患者前往急诊科就诊的最常见原因之一。了解急诊医学——尤其是奥克施纳健康系统的急诊医护人员——对阿片类药物危机的影响至关重要。基准处方数据表明，奥克施纳健康系统急诊医学医护人员的阿片类药物处方率显著高于全国急诊医学平均水平。
方法
从该机构的电子健康记录系统中提取与就诊和阿片类药物处方计数相关的数据。计算每位医护人员的阿片类药物处方率。启动了一个数据透明度项目，在该项目中，医护人员的阿片类药物处方率不再保密，并在医护人员群体中进行公布。
结果
在为期1年的项目期间，急诊服务的阿片类药物处方率总体从22%降至14%。一些医生的处方率降低了70%。重要的是，阿片类药物处方率下降并未对患者满意度评分产生负面影响。
结论
使用不保密且透明的数据分析来提高医护人员表现的透明度，可以有效且显著地改变医护人员的行为。
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