Engaging Patients and Retraining Professionals on Multimodal Pain Control and Opioid Alternatives
The preliminary modules of Engaging Patients and Retraining Professionals on Multimodal Pain Control and Opioid Alternatives: A New Hybrid Training Program for Your AEI introduce the practitioner to screening, risk assessment, intraoperative alternatives to opioids, and best discharge practices. A skills component is forthcoming and complements the online didactic portion (with the complete set of modules to be posted by August 2019); individuals, practice groups, or hospital systems will obtain credentialing upon successful completion of both components in their entirety.
It is estimated that 312 million operations occurred globally in 2012 (Weiser, Haynes, Molina, et al., 2016) with 60 million procedures performed in the United States (Hall & DeFrances, 2010; Cullen & Hall, 2009). Additionally, an average of 6.2 percent of surgical patients continue to use opioids for 3 months following their operation (Brummett, Waljee, Goesling, et al., 2017). This potentially equates to 18 million people each year using opioids subsequent to their recovery period.
While there is an increased overall national awareness of the opioid epidemic with policy and education resources focused on professional training for chronic pain control, specific education for the surgical community—including professionals, patients, and families—are limited.
A 2017 American College of Surgeons (ACS) survey identified that:
- 87 percent of responding surgeons’ patients experienced side effects from opioids when taken for the management of postoperative pain, yet 82 percent of surgeons did NOT have print or other materials they could use to help educate their patients on opioid use, abuse, and alternatives (Heneghan, Daly, Sachdeva, & Barrot, 2018).
- Multimodal pain control was identified as effective and 90 percent of surgeons reported using local anesthetics as part of their pain control plan.
- Equally important, 52 percent of surgeons stated their patient population had used opioids in the past month prior to their operation, yet only 17 percent had any protocol for managing patients who were opioid dependent (Heneghan, Daly, Sachdeva, & Barrot, 2018).
- In a 2018 course attended by 60 surgeon leaders responsible for implementing opioid-sparing system changes at their surgical facilities, 75 percent requested assistance from the ACS for further professional education on local anesthetic use for major surgical procedures (report summary given at ACS Clinical Congress 2018).
This course includes training and reinforcement on best practices and standards for pain control.
Introduction to the Opioid Crisis and the Surgeon’s Role
Bridgette N. Fahy, MD, FACS; John M. Daly, MD, FACS, FRCSI(Hon), FRCSG(Hon); and Kathleen Heneghan, PhD, RN
- Introduction to the Problem
- Functional Assessment
- Communication and Patient Education Strategies
- Systemic implementation, quality initiatives, strategies
Best Practices for Opioid-Sparing Techniques Including Indications, Modifications, Complications and Safety Monitoring
Phillip Lirk, MD
- Opioid-sparing Techniques
- Local Anesthetics
- Nerve Blocks
- Wound Infiltration
- Long-Acting Local Anesthetics
Screening Surgical Patients for the Risk of Opioid Abuse
John M. Daly, MD, FACS, FRCSI(Hon), FRCSG(Hon), and Kathleen Heneghan, PhD, RN
- Communication with the Patient
- Pain History
- Screening Tools
- Screening Tools for High-Risk Patients
- PDMP Use
- Informed Choice
- Setting Expectations
- Current Medications and Non-Opioid Options
- Discharge, Follow-Up
- Communication with the Patient’s Primary Care Physician
These courses can be taken by any member of the health care team or patient safety experts to support the didactic portion leading to the eventual credentialed training program on improving surgical patient outcomes and minimizing risks with opioid sparing pain control. Prime participants include:
- Physician assistants
- Home care providers
- Nurse aids
- Patient safety experts
Thomas A. Aloia, MD, FACS
Chad Brummett, MD
John Daly, MD, FACS, FRCSI (Hon), FRCSG (Hon)
Michael J. Englesbe, MD, FACS
Bridget Fahy, MD, FACS
Jessica Lynn Gross, MD, FACS
Kathleen Heneghan, PhD, RN
Lawrence Iteld, MD
Phillip Lirk, MD
Lisa M. Mazzia, MD
Michael F. McGee, MD, FACS, FASCRS
Jonah Stulberg, MD, FACS
James Ray, PharmD, CPE
Michael Reinhorn, MD, MBA, FACS
Scott Weiner, MD, MPH
No CME will be offered during this pilot workshop