Hospitals and health systems are experiencing the damaging effects of the opioid epidemic on a daily basis.
Emergency departments and inpatient beds have been flooded with those suffering from the destructive consequences of opioid abuse and addiction. Further, the number of fatal drug overdoses in 2016 alone surpassed the number of individuals who died during the HIV/AIDS epidemic at its peak in 1995.
Recognizing this reality, hospital and health system executives need to expand their role in addressing this national and local crisis. However, the vast and complex nature of the epidemic—combined with the historical lack of localized opioid-related population health indicators—can leave executives feeling overwhelmed and unsure of the best path forward.
To help hospital and health system leaders build a proactive and comprehensive response to the opioid epidemic, Advisory Board Research conducted interviews with executives from leading organizations across the country to identify best-in-class strategies. The resulting insights outline key components of an effective approach to confronting the devastation of the opioid epidemic by preventing misuse and addiction and supporting recovery through expanding access to care for those with opioid use disorder.
The nine imperatives for health system executives include:
• C-Suite commitment: The mandate for improving opioid prescribing behaviors must come from the C-suite. Executives should establish preventing new misuse and addiction as an organization-wide priority.
• Clinical Standardization Pathways: Executives should engage clinicians in improving opioid prescribing behaviors by combining existing care design strategies with opioid-specific education.
• Specific Education and Protocols: Given the history surrounding opioids, leaders should overinvest in specialized support to help clinicians understand when to prescribe opioids and how to do so safely—or when it’s best to explore other pain management options.
• Patient engagement: Beyond supporting clinicians, executives should also empower patients with education, resources, and accountability mechanisms to achieve safe opioid-use behaviors.
Additional details on these and the remaining imperatives are available to Advisory Board Research members in the new white paper Confronting the Opioid Epidemic: Nine Imperatives for Hospital and Health System Executives.
Analysis of Key Performance Indicators Reveals 3 Widespread Opportunities
To help inform this analysis and further support hospital and health system executives, Advisory Board Research and OptumLabs collaborated to develop an analytic tool, which provides a clear visual understanding of the status of the opioid epidemic in any selected region and pinpoints areas of greatest clinical need. The tool is populated with data from the OptumLabs data warehouse and draws upon 29 key performance indicators (KPIs), a set of outcome and process measures, developed by OptumLabs. This set of measures is designed to help leaders plan their strategic response to the opioid epidemic and mark the progress of their interventions. The metrics encompass four domains: prevention; pain management; opioid use disorder treatment; and maternal, infant, and child health.
Advisory Board and OptumLabs found the data show three immediate areas for health care providers to improve performance. First, the KPIs reveal dramatic regional variability, especially in initial prescribing patterns of opioids related to duration and dosage. Providers should familiarize themselves with the 2016 CDC prescribing guidelines and ensure they understand the specific needs of their local region when prioritizing interventions and crafting clinician communications.
Second, in accordance with CDC guidelines, hospitals and health systems should work to ensure that opioids are not the default option for chronic pain. This calls for first working with local providers and community organizations to increase access to alternative forms of pain management. Next, executives need to work with clinicians to lower barriers to prescribing these alternatives. These tactics will help to prevent new cases of opioid use disorder and complement medically necessary, low-dose opioid prescriptions. They will also help clinicians treat individuals suffering from both chronic pain and opioid use disorder.
Finally, hospitals, health systems, and key community stakeholders should increase access to medication-assisted treatment (MAT), particularly in cases following an overdose or when a patient suffering from opioid use disorder is identified in the hospital setting.
Tailor Strategy to Local Factors
Building on these best practices, every hospital and health system should develop its own strategic approach to preventing and treating opioid use disorder. Leaders should not, however, overlook the practical challenges of implementing a comprehensive opioid response strategy. Few organizations are able to deploy every tactic to confront the opioid epidemic at once. As a result, success requires prioritizing the highest impact elements of the organization’s intervention strategy. The best way to do this is to take a two-pronged approach.
First, hospitals and health systems should identify the areas of greatest local need. Second, provider executives should consider what actions lie within their organizations’ direct scope of control and pursue those initially.
Our industry stands at a pivotal moment—one unrelated to national elections or payment models or new competitors. Our patients, our communities, and our organizations are experiencing the devastating consequences of the opioid epidemic on a daily basis. Fortunately, through effective leadership and the right strategies, hospitals and health systems are poised to play a central role in confronting the opioid epidemic.