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Georgia Hospital Engagement Network
Hospital Acquired Condition Affinity Webinar Series 3/19/2014
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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
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Re-evaluating Safe Perioperative Pain Management
National Procedural NO Harm Affinity Group Roy Soto, M.D.
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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
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Overview Assumptions MHA pain management toolkit MHA data measures
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Pain is Poorly Controlled
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Opioids Cause Harm 2001 2012
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Pain Control Drives Satisfaction
Hospital X HCAHPS/Hospital Compare
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Pain Control Enhances Recovery
↓opioids/↑multimodal analgesia leads to Earlier return of gut motility Earlier enteral feedings Earlier mobilization Earlier removal of drains/catheters
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Implementation Baseline data collection Implementation of MOSS tool
Gap analysis Outcome and process data Implementation of MOSS tool Education Physician Nursing Patient Reassessment and refinement
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Implementation
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Implementation Patient Education
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Gap Analysis Tool
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Michigan Opioid Safety Score
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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 15
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Process & Outcome Measures
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Educational Product Powerpoint with voiceover Live presentations
Surgeon Anesthesia Nursing Live presentations +/- CME/CE Patient print product
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Dynamic Processes
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Contact Information Michelle Norcross, MSA Michigan Health & Hospital Association Keystone Center Project Manager Roy Soto, MD Beaumont Health System
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