HCA Healthcare Magazine - Winter 2019 - 11

FIGHTING
BACK

4,982 lbs.
Approximate weight of

medications-equaling more
than 3.42 million doses-
collected during take back
events across 96 locations
in 16 states in fall 2019.

84

HCA Healthcare hospitals

were employed at 140 of our facilities, with the goal to have
the program in place in all facilities, in at least one major
service line, by the end of 2019. ALTO protocols are also
expected to be expanded enterprise-wide by then.
"The crisis pressed us to develop a more comprehensive
approach to evidence-based pain management," explains
Dr. Schlosser. "In the past, how doctors decided to manage
their patients' pain was largely their individual decision.
But now we've engaged them in developing and deploying
solutions like ESR and ALTO to reduce risk and improve
outcomes for patients."
Dr. Schlosser serves on the Opioid Prescribing Guidelines
and Evidence Standards committee, which works to better
understand pain and its role in recovery from injury or surgery. He says pain is "something that should be managed,
but also at times accepted. We're also much more interested
in alternatives and nonpharmacologic approaches."

that partnered with local
law enforcement during
the Crush the Crisis opioid
take back day this fall to
collect unused and expired
prescription medication
from the community.
(More sites are continuing
to participate in take
back days and partner with
local law enforcement
throughout 2019.)

52%

The highest reduction in opioid
usage, due to procedurespecific variation, experienced
by patients who participated
in the Enhanced Surgical
Recovery program.

$500K

HCA Healthcare's monetary
commitment to the National
Academy of Medicine's Action
Collaborative on Countering
the U.S. Opioid Epidemic.

Photo (from left): Therese Naguib,
Rani Mathews and Steve Stephens with
the permanent medication collection box
at Medical City Frisco in Frisco, Texas.

Finding Success
Just as key, our data reveals that the percentage of patients
saying their pain-control goals were met in the ESR
program is greater than the patients outside the program
having the same surgeries-with roughly 35% fewer opioids
used, says Dr. Schlosser.
Another key weapon: the Electronic Prescribing of
Controlled Substances (EPCS)
program. It allows better access
to electronic health records,
making it harder for drug
seekers to doctor-shop or alter
prescriptions. EPCS builds on
the controlled substance monitoring guidelines developed
in 2013 by HCA Healthcare's
Physician Services Group.
"We cannot immediately
undo what has been done for
the last 25 years," says Dr.
Hodrick. "Rationing programs,
while effective, can leave some
patients under-treated.
As a medical community,
we must all be committed to
deemphasizing opioid medicine
as the cornerstone of recovery
after surgery. We must continue
to seek alternative methods to
help decrease the suffering
of our patients." ■

"Healthcare
providers are very
open to the
conversation about
opioids . . . While
there still is much
debate about the
right use of opioids
to be had, the
public awareness
has smoothed the
path for a greater
conversation."
-Michael Schlosser, MD, MBA
Vice President of Clinical Excellence
and Surgical Services,
HCA Healthcare

HCA Healthcare Magazine | 11



HCA Healthcare Magazine - Winter 2019

Table of Contents for the Digital Edition of HCA Healthcare Magazine - Winter 2019

HCA Healthcare Magazine - Winter 2019 - Cover
HCA Healthcare Magazine - Winter 2019 - 2
HCA Healthcare Magazine - Winter 2019 - 3
HCA Healthcare Magazine - Winter 2019 - 4
HCA Healthcare Magazine - Winter 2019 - 5
HCA Healthcare Magazine - Winter 2019 - 6
HCA Healthcare Magazine - Winter 2019 - 7
HCA Healthcare Magazine - Winter 2019 - 8
HCA Healthcare Magazine - Winter 2019 - 9
HCA Healthcare Magazine - Winter 2019 - 10
HCA Healthcare Magazine - Winter 2019 - 11
HCA Healthcare Magazine - Winter 2019 - 12
HCA Healthcare Magazine - Winter 2019 - 13
HCA Healthcare Magazine - Winter 2019 - 14
HCA Healthcare Magazine - Winter 2019 - 15
HCA Healthcare Magazine - Winter 2019 - 16
HCA Healthcare Magazine - Winter 2019 - 17
HCA Healthcare Magazine - Winter 2019 - 18
HCA Healthcare Magazine - Winter 2019 - 19
HCA Healthcare Magazine - Winter 2019 - Back Cover
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